Dr. Bernstein's Diabetes Solution book

Lee Ann…I did bring half my burger home…I am not always successful in that, tho.
I am on MDI, so with that sort of meal profile, I usually will spread out the dose a bit which is a pain as I am shy about “shooting up” in public. As you say, eating like that is not a very frequent thing, but anything we can do to better our control is great.

The diet isn’t hard to follow. Once you get the hang of it and get your insulin doses adjusted it’s pretty consistent. Ive been doing it for about 1.5 years now and have been in 4.3-4.5 range on all my HbA1cs. All my numbers have improved: cholesterol, triglycerides, blood pressure, etc. This is the way we were designed to eat: meat, vegetables, nuts, and fat. It’s backed up by science. You won’t be able to hit up the DQ for a banana split or BK for the Double Whopper value meal, but your risks of getting complications will be slashed. You dont’ have to be perfect on the plan 85% good 15% bad for some fun. A lot of his patients are able to reverse some of the damage already received from poor control.

Once you make the switch to this program all the cravings disappear. I used to be the worst eater, lots of fast food, and junk, and I don’t want it anymore. If I were to go and get a milkshake somewhere right now it would be like a street drug. It would taste awesome but Id be junked up afterwards from all the insulin and the biochemical onslaught from all that sugar. I think it comes down to doing what will allow one to get the best control achievable in one’s personal situation and environment (Diabetic Individuality).

Neal…I’ll let you be my inspiration.
My trouble, despite the burger and fries story, is not giving up junk, it’s giving up what used to feel healthy…a slice of ww toast with my eggs, brown rice with my chili, sweet potatoes, beans, fruit. It’s hard to change the meals I put on the table for my family…routines. I was able to do it for a while, I’ll get back to it (Monday?) I’m just saying that it’s not just giving up junk…I’d already done that.
That said, you either make the commitment or you take your chances…
Sorry, David, if I keep steering the conversation away from your initial questions.

Hi, David,
I read Dr. Brenstein early on and for me the most important point he makes is that people with diabetes can have normal blood sugar and therefore avoid future complications. The medical profession doesn’t necessarily tell you this, and the ADA guidelines will not usually result in normal BG because the recommended diet is too high in carbohydrates. Dr. Bernstein’s recommended amounts of carbohydrate are very restrictive and may not be necessary for all people who want to achieve normal BG. I did follow the diet pretty strictly at first because I was misdiagnosed Type 2 and had to use diet and exercise only. I went from an A1C of 7.2 down to 5.6 in 3 months. My cholesterol levels were fine- high good cholesterol and very low tryglycerides. I also lost 30 pounds which I was not trying to do- I am already very thin, but this was a result of keeping my BG within that narrow band and avoiding the spikes which had given me extra insulin releases and driven me low. I was swinging between 200 and 50 with even the smallest amounts of carbs. When I was low I got headaches and was hungry and tired and then I would eat a couple of bananas and go way high again. After about 6 months I had the antibody tests which confirmed I had LADA and I started on insulin. I now do a modified Bernstein diet- some fruit and lots of raw food, cheese, nuts, some fish and meat. I sprout whole grains, legumes, and leafy greens and that’s a big part of my diet. I eat no more than 20 or 30 grams of carbs at each meal and do 2-4 units of insulin. All my carbs are from high fiber fruits and non-starchy vegetables- no rice, pasta, potatoes, baked goods or processed foods. My last A1C was 5.3. I find it easier to completely cut out all the foods that spike my BG rather than have to make the decision at every meal or snack if I am going to have some and how much. I don’t have many cravings anymore and find most carbs just don’t taste good to me. I do miss bread and mashed potatoes and have small amounts when I eat out but not when I’m home. I think there is a little more leeway than Dr. Bernstein realised because he wrote his book before CGMS showed us that regular folks do go up to 120 after eating. So I allow myself to eat the fruit that takes me over 100 and know that I am still staying in the normal range. I also don’t worry about the occasional meal out that takes me above 140 but otherwise try to follow his “law of small numbers”. I just can’t stay in the normal range with larger amounts of carbs even with larger amounts of insulin. I either go high or low or both. The added bonus is that this diet makes me feel great- I am full of energy. So, I recommend doing whatever works to try and mostly keep your BG in the normal range, which is 80-120 at all times. (Even in the hour after eating).

Libby…you always spell it out so clearly and have wonderful advice at making it work…More inspiration! Thanks.

Elaine, I don’t think Id be able to pull this type of control with a family to raise and feed in addition to work. Probably still possible but would be tough to pull off. Gotta give you a shout out for your hard work. Would be too much for me to handle.

Sounds like a very interesting book and one worth reading (regardless of what you decide to do with it). Fortunately there are Type 1’s among us who have had this disease for 50+ years without developing complications. Joslin recently conducted a large study with 300 participants (my Uncle being one of them) to determine what commonalities these people share. The results will be interesting! My uncle is going on 60+ years with no complications. He has always consumed pasta, potatoes, breads etc. While he is consistent about consuming these carbs at very reasonable portions, he does eat them, and usually on a daily basis. He maintains that exercise and persistence/determination have been keys to his success. His favorite motto is “control your diabetes, don’t let it control you”. This sounds like an interesting book and one definitely worth reading. While we know it’s imperative to strive for healthy BG’s/A1C’s, we all have unique needs and reactions to various foods, insulin/excercise regimes and diets. Thanks for sharing info on this book I am planning on getting a copy soon!

I would like to thank everyone for the replies. It seems like the consensus opinion in the post is that “yes” you can eat carbs at every meal but you should consume waaaaaaaaay less than the ADA recommendations of 75 carbs per meal. Most people who are disciples of Dr. B seem to recommend anywhere between 10 to 40 carbs per meal. Up until this point, I have been following the ADA recommendations of 75 carbs per meal and my A1C’s have been averaging around 5.9. As of today, this moment, I am going to switch to the “Dr. B diet” and see if I can get my A1C below 5. Thanks for all the personal stories and encouragement from everyone on the post and for responding to my questions.

Though raised in Missouri and now living in Florence on the Oregon coast, I spent 25 years in Minnesota. Lived in both Mpls and St. Paul, but spent lots of time “up north.” I especially love the North Shore of Lake Superior and the Boundary Waters.

After being diagnosed as Type 2 in 1999, I managed fairly well with diet and exercise alone for five years. Began metformin about three years ago, but spiraled badly out of control, due mostly to denial and worsening insulin resistance. Last November after turning 58, I suffered a major stroke. In the hospital, I learned that my A1c had been almost 12.

Seven months later, I’m on a basal-bolus insulin regimen (Lantus & Humalog) yet find it shockingly primitive, despite 8+ fingersticks and 6+ injections per day. I spend too many days chasing my blood sugar. While I would love to stay in the “normal” range (80-120 mg/dl) all the time, that would require the multi-phased “cascading bolus” approach of another poster in this thread.

I read the 1st edition of Richard Bernstein’s book back in 1999. This spring I read the newest edition. My, how things have changed. I don’t consider Dr. Bernstein to be “crazy” or extreme at all, just serious and careful. Keep in mind that Bernstein is a Type 1 who’s spent a lifetime running up against misinformed medical bias. He’s seen people die from horrific complications after following status quo medical advice, and he’s had to get tough to survive all the institutional BS.

I certainly understand people longing for the comfort of carbohydrates. If you can do that, great! My diabetes is sufficiently advanced, however, that I no longer have the luxury of food choices based solely on what I want. I’m already crippled from the stroke. For me, the question of survival is no longer hypothetical.

I was both very impressed and horrified by Dr. Bernstein’s book. His diet would be impossible for many to follow and I could not put a child on such a diet. Although I know some have. I can try to get her to eat healthier carbs, lower glycemic index foods. And can and do reduce carbs during high periods, out of necessity until BS comes down.

Sorry to hear about your health problems. I hope you find the low carb approach works for you. I believe Dr. B. has found that some complications can be slowed or reversed if you keep your BG normal. I agree with you that it is almost impossible to do this with the ADA diet, regardless of whether you use insulin or not. I just got back from a vacation where I relaxed my strict diet and had many more high and low episodes than I would on my modified Dr. Bernstein diet.

My ophthalmologist, one of the premier retinal specialists in the Philly area, said there had actually been improvements in my retinal microvasculature from previous visits to the most recent one (I’ve seen him since I was 12, and he performed my vitrectomy 10 years ago - I owe him my sight). Additionally, my labs reflecting kidney functions had improved last I saw my nephrologist. I attribute those improvements to having brought my A1c down, really reigning in my BG’s. I don’t know what the exact ADA recommendations are, but I like my carbs and eat them, as I said in previous posts in this thread. In my case, I’ve found that moderation and portion control combined with an emphasis on healthy carbs has been key. I just hate to see people deprive themselves of foods they like, thinking that’s the only way to improve BG control and ward off complications, stop them in their tracks or even reverse them.

Bill…I am sorry for your lingering medical problems, but thank you for sharing your situation. I can learn from it. I am happy you are working toward a healthier future.

Lee Ann…another inspiring story. Congrats on your improved numbers and health.

an adkins diet huh? that is a tough one. For me atleast, it might be because i grew up eating almost anything and e everything. why not try a low carb diet??? its all about portion.

The Adkins’ diet was mentioned. If you have an Adkins’ Carb Gram Counter, notice that the book implys that you can substract carbs by substracting fiber and arriving at “net carbs.”. This is unworkable for a diabetic. Your system has to deal with all the carbs you consume, no matter how much fiber you eat. Food labels are doing this, too. You will see “net carbs” on many products. Fiber may have some affect on slowing absorbition, but forget this and pay no attention to net carbs is my way of thinking.

I forget…what does Dr B say about this?

Fibre passes right through you without affecting BGs. The can be considered for timing purposes, but we should not bolus for them. Typically they are such a small percentage that idetifying any difference is impossible anyway.

Speak for yourself. When I’ve not counted the fiber, my BG’s end up out of range. When I do count it, they stay stable. I’ve heard lots of others say they consistently have the same experience.

He’s not alone. Others, notably Taubes, make similar conclusions about carbohydrates: http://abcnews.go.com/GMA/story?id=3654291&page=1 He contends that insulin drives fat and carbs drive insulin. The way to lose weight is to cut back on carbs. Diabetics here and elsewhere tend to do very well with this. I have just started reducing my carbs and I see dramatic differences in 2.5 weeks. I’ve lost 5 lbs and my insulin sensitivity has shot way up. I still have long term worries. I think growing children need carbs.