Dr. Bernstein's Diabetes Solution book

I picked up this book and read the first chapter on it. Any takes on Dr. Bernstein’s recommendations? From what I gather, based on reading only a few pages of his book, he seems to recommend the Adkins diet in order to avoid fluctuations in blood glucose. Basically, his plan for living a long life as a type I diabetic, is that you can’t eat what you want—only vegatables, fish, cheese, and meat. This seems like nearly impossible diet to follow over the long term–at least, for me.

I bought this book a few weaks later, I didnt finish it yet, but if you really analize what he saids it have a lot of sense.... I dont know if I could follow that kind of diet over a long term too, I love carbs!.. but I knew people who follow similar low carb diets and I just cant believe their numbers!!!!... they really are about 90's.. 80s all day long! and HbA1c on 5%… 4.8%…

I think that the Dr. Bernstein’s proposal is an option…but it’s not for every one… ( but I have to confess that I feal really curious to at least try it)

I don`t know much about Adkins diet do you have some information??

There’s enough crap we have to monitor and be vigilant about as type 1’s. I’m going to eat the things I like, heavy on the fruits, veggies, whole grains and lean proteins, but not excluding anything I like including “treats”. I think it’s unhealthy to exclude or limit an entire category of food, especially long term, and especially one that is filled with dietary components we need to function optimally (i.e. vitamins, minerals, etc.). Of course, I don’t believe in “diets” more generally speaking. Dieting is ultimately an unproductive power struggle with yourself that you just can’t win when everything is said and done.

Personally, I’d rather have an HbA1c of 6% and eat all the foods I like without feeling deprived and restricted, than have an HbA1c of 5% and miss so many of the foods I enjoy. I’m not compromising my health or quality of life, which for me includes the pleasure of food.

The most important thing I learned from his book was to start thinking about eating like a diabetic, not like a “normal” person. I know it sounds weird, but hey, diabetes is freekin weird. Sometimes it means you gotta eat like a weirdo.

To a certain extent I believe in his concepts, but I’m not religious about it:

Do I eat carbs?..yes.

Do I eat a supersized order of fries and try to cover it with an ungodly amount of insulin?..no.

If I did eat those fries would my blood sugar spike regardless of the amount of insulin I took?..most likely.

If my blood sugar is 50 half the time and 200 the other half then will my A1 show an average of 125?..yes.

Does this mean I have good control?..of course not.

Is diabetes easier to manage when you restrict carbs, pay attention to glycemic index, and reduce daily insulin amounts?..oh heck yes.

I’ve said it before so I’ll say it again: Diabetes is a mind game. His book helped me develop a mindstate that is no longer trying to eat like the people around me…I’ve accepted that I just can’t. I’m totally OK with that.

A few months ago, I decided to change my lifestyle and based a lot of my diet regimen on Dr. Bernstein’s book. I go for six small meals a day, mostly protein. A few scattered carbs here and there, mostly burned off in the gym. I’ve been able to reduce my Lantus by almost 50% and I’ve lost inches and weight. My blood sugar numbers have never been better…diabetes gets a whole lot easier when you stop “feeding” the insulin.

I do think his actual diet plan is a little extreme and unrealistic, but it is still a good book with a lot of key concepts and philosophies. We as diabetics have been brainwashed by the ADA and their diet suggestions, it’s good to see the other side of the coin. Dr. Bernstein is actually one of us, and he speaks a lot from personal experience, which I can respect.

An absolute must read.

To be fair, if you’re on a pump, and your basal rates and insulin to carb ratios are correct, you really aren’t feeding the insulin. I was on injections for 26 years so I remember feeding the insulin, and pumping for the last four years has freed me from that.

If you’re happy with the restrictions, that’s your choice, but I think most people end up miserable with restrictive diets. Back when I was a kid and we all did the “diabetic diet”, I know I constantly felt left out, deprived, and unhappy with having to eat differently from everyone else. Diets of any kind are not reasonable life-long solutions for the majority of people with diabetes. Moderation is so important, and it offers more flexibility than “diets”. There are already so many things with which we have to be less flexible than non-diabetics (when is the last time you were able to dash out of your house without your diabetic tool kit?), that to have a realm in which we can be normal (yet healthy!) is one less burden. Not that there aren’t nutritional tactics you mentioned that aren’t worth implementing (several smaller meals as opposed to three larger ones, for example), but having grown up during a time of universal dietary restrictions for all diabetics, I don’t think unnecessary dietary restrictions offer the most healthy approach from a more balanced and holistic perspective. That’s just my opinion based on my life with type 1 (most of which has been unpleasantly tumultuous), and what I can gather from conversations I’ve had with other vets.

Different things work for different people of course, but I like other type 1’s to know they can eat normally as long as they do so mindfully and moderately, and still be in excellent control.

It seems as though that most people agree with the premise of Dr. Bernstein’s book but just find it difficult to have a lifestyle in which they are eating a minimal amount of carbs. I think Bernstein’s point is that we, diabetics, are already extremely inconvenienced by the fact that that we are type I diabetics, isn’t it worth that one extra sacrifice in order to have your glucose levels nearly the same as non diabetics? To a certain degree I agree with a lot of comments on the post, it would really suck (for lack of a better word) to follow Dr. Bernstein’s recommendations 100% all the time and never be able to eat the peach pie over the holidays, the famous apple strudel, etc. However, based on my personal experiences, the only way I have been able to keep my sugars steady is by eating a low carb diet with lots of exercise, which is exactly what he recommends. All of the things that I have been doing through trial and error to keep low blood sugars is what he recommends in the book. So, the book really validiates what I have already been doing. I must say his recommendations are accurate but it really sucks not to be able to eat carbs without messing up your sugar. They need to figure out a way to get our pancreas working in the same way a non diabetic pancreas works. But, I am not holding my breath that this happen soon.

I think that Dr. Bernstein’s ideas make A LOT of sense.

and like Dino, it changed my approach to diabetes, but I too like carbs and consider them to be part of my healthy lifestyle. I can’t imagine eating such low carbs. He recommends 6 g for breakfast, 12g for lunch, and 12g for dinner. But many people do this…

I have given myself a couple years to see if I can get an A1c under 6 WITHOUT going extremely low carb and without lots of lows (i.e. actual good control, not just a low average). I am playing with the timing of giving insulin and using dual wave boluses to see if I can eat a 40-60g meal and have normal blood sugars.

I have signs of hope. If I take my insulin one hour early in a dual wave bolus (50% given upfront, 50% over a hour), I find that my blood sugars can be under 120 within an hour… and stay there.

If my control is not extremely good a year from now, I will try the Bernstein road…

Lee Ann,
Well said I am with you.

I think you are right on target. Been right where you have been on the pump sence Feb last year Life changing.

Lee Ann, thank you for reminding me that the quality of life is as important as a lower A1c! Happy Fourth.

We all seem to agree, here. Dr B’s premise is accurate and we try to adhere, within reason. Sometimes, it is worth a little less control to have that treat. My problem is that once I slide, I keep sliding…hard to get back in the pattern. I might need to pick up the book every few months for inspiration. I did loose 9 lbs in a couple of months not trying…just strictly limiting carbs. Has anyone had their lipids checked after eating all that cheese, eggs, nuts, protein…?

For those of you who take half their bolus an hour before eating on, let’s say on a 60 carb meal, do you ever get extreme lows before actually eating? Then, when you check your blood glucose after the meal and you see you have a 120 blood sugar, how do you know that insulin is not going to kick in and knock you down to like a 50 blood sugar? Second question, for those of you who follow Dr. Bernstein’s crazy diet for the most part, what kind of reductions did you see in your AIC from before and after? You don’t need to give me exact numbers because that’s pretty personal information but you can say I went down “1.3” or whatever it was.

Hey Judith! Yes, got to love the dark chocolate! It also helps me very much that Dr B is pretty tolerant of alcohol! I enjoy my cocktail hour with a glass or two of wine and some nuts! (another vestige of scandinavian heritage! By the way, we just watched the movie Sweet Land about Norwegian immigrants in MN…very touching.)

You made a great point. Not that it makes it easy, but it helps to remind ourselves that making the right choices now, allows us to , hopefully, not have that lack of option later on.

I’m glad you are doing so well under Dr B’s plan. Great A1c!

I do the early bolus and check often (before bolusing, before eating, one hour after eating, two hours after eating). I’m trying to get tight control so I am experimenting with what works now!

I have had some lows, but those were when I forgot to eat on time.

Now I have a kitchen timer that i set so that I don’t forget to eat at one hour.

If my blood sugar is below 85, then I eat right when I take my insulin. 85-100, I eat after half an hour.

When I am 120 an hour after eating, the insulin is still active, but I am also still digesting my meal… so it usually balances out.

I don’t do this all the time. Only when I am at home. But it seems to help. If you do it, you have to check your blood sugar often.

I went to the endo (new one) Wednesday, and she asked me why I bolus 20-30 min before eating. She thinks it is unnecessary. She even asked me who told me to do that! I’ve been doing it for at least 15 years!

I found out about bolusing early on TuDiabetes! My doctor had never mentioned it!

But when you check out the activity of insulin, it makes sense!!

I take my bolus right when I eat or very shortly thereafter. It depends on what I’m eating. I tend to eat a lot of fruits, veggies, and whole grains, so the fiber helps modulate my BG. I also do combo boluses most of the time, and the percentage of upfront vs. extended varies depending on what I’m eating, whether or not I’m taking the insulin before or after I eat, and what my activity level is. I’ve played with it in order to get a fairly straight line on my CGM after meals. Part of how I decide to take my insulin is based on logic and part of it is ‘diabetic intuition’. Sometimes it’s off, but sometimes it’s right on. A couple of weeks ago, I went out for ice cream, and the timing and percentages of my combo bolus was perfect - my BG hovered around 90-100 even after the ice cream! When and how to take it is very individualized though so people have to play with it and see what works best.

I would love to hear tips on making this work out of the house. I bolused a tad aggressively in anticipation of a bluecheese burger with fries (I know! Half the bun and just a few delicious fries,) and the waitress came and told us that our food had been given to someone else. I asked her to bring me some juice and she didn’t so I went to the bar and got my own. I can imagine a hundred scenarios at work that could be problematic.

My first endo told me there was a 15 minute leeway either before or after. Like you, Kristin, I’ve learned otherwise from this site and try to beat the spike.

You didn’t say if you had done a combo bolus. With such a fattening meal, it’s essential to do that because the fat modulates the BG spike over time. When I have a really fattening meal like that (fries, burger, wings, pizza, etc.), I’ll spread my bolus out over an hour or even an even an hour and a half, again, depending on circumstances like current BG, activity level, etc.

I’ve also become the queen of doggie bags. I almost always eat just half of my meal, and take the rest home. That right there has been one of the best things I’ve done to help manage my BG’s and keep my weight down while still allowing me to eat those kinds of foods. Not that I eat that stuff on a regular basis, but when i do, I can make it work.