"The Diabetes Diet" by Dr. Bernstein

Hi:
I have made the decision to start living a low carbohydrate lifestyle. Granted, I've already cut my carbohydrates substantially (upon diagnosis). But I feel like I could do more in my treatment.
Anyway, I happened upon "The Diabetes Diet" by Dr. Bernstein.
I was wondering if this was a good option?
Oh, allow me to preface by stating that I am NOT trying to lose weight. Weight loss is NOT an issue of mine. As a matter of fact I want to start using insulin so I can regain the weight I've lost.
So, would this still be a good starting point for someone like me?

For me, I find Dr. Bernstein to be too rigid, too narrow minded, and too old-fashioned. But I do think that it is a good starting point, to figure out what works best for your body. You can probably get some good ideas from the TuD low carb groups. Unlike many of the low carbers here on TuD, very low carb just doesn't work for me, but moderately low carb is absolutely the way to go. Too low carb for me means terrible headaches, and being crazed with hunger all the time. Not pretty. So I eat fruit especially to fuel my workouts and vigorous yoga practices, and I eat some of the higher carb veggies. Finding out what works best for you is the way to go!

I’ve followed Bernstein for years. I’m not as strict as he recommends (6-12-12), but I do follow a verycab low carb diet. I recommend his book “Diabetes Solution” rather than the diet book.

There are many around here who say reading Bernstein's book changed their lives, me among them. Although there are some who follow 6-12-12 very strictly, there are just as many who are not as strict. I think there are two things which all followers have in common.

First whether you are T1 or T2, your body has problems metabolizing carbs. So some form of carb restriction is beneficial. For T1's lowering the carb intake makes it easier to estimate the carb load in a meal and thus calculate the correct dose of insulin thus avoiding highs and lows, the so called "Law of Small Numbers". For T2's it enables one to match the carb load in a meal with ones body's ability to successfully metabolize it.

The second takeaway is that the source of carbs matters, all carbs are not created equal. Grains, sugar, fruit legumes etc. cause problems with control in both groups and both benefit from eliminating these sources from their diet.

I eat between 30 and 50 g/day, and eliminating the aforementioned problematic carbs is the important thing. When your main source of carbs are things like broccoli it's hard to rack up mega carb totals in a day. Since they hit my bloodstream at a slower pace it helps my pancreas keep up.

Thanks!
Yeah, I love fruit too much to be too rigid about it. So I am definitely going to read the book and then tailor it to my own low carb plan.

I also eat low carb, around 30 a day. It works for me, I'm not hungry, and I eat great food.

I totally agree with bsc- get "Diabetes Solution". I think if you're serious about it, his plan is probably a good place to start then tweak to what works for you.

I read the diabetes solution recently and was totally on board with it...until I got to the point where the man said he hadn't had a piece of fruit in over 40 years. What, what?! And then I read I would have to cut out things I love like tomatoes, balsamic vinegar, and onions! I love those things! Not consuming them would send me spiraling into a deep dark depression. Also, I am not knowledgeable enough about insulin to follow his insulin plan, so I try and stick to what my endo tells me to do (I'm a rule follower at heart). I guess for me I do feel like the science behind what he says is solid, but there is no way on this green earth that I am going to go completely carb free. Especially if it means eliminating things I love to eat that are good for you. My own personal goal is to not give myself more than 4-6 units of fast acting insulin a day. And I'm reserving the 5-6 units for holidays and special occasions. That being said I will say fruit can send my sugar through the roof! I've cut out a lot of fruit-citrus, grapes, bananas, melons, berries for the most part. I've replaced my morning bagel with an egg casserole (I make it once a week and microwave a piece each morning) and dinner I try to do only meat and veggie (or salad). I'm not great at pounding the gym, but I do try to keep moving all day long and try and go walking regularly. It's such a balancing act I feel like and right now it doesn't feel too hard to keep up and do the healthy things. Transitioning to type 1 hasn't been that hard for me yet, but I do worry it will all come crashing down around my ears one of these days. I keep meaning to read 'Think Like a Pancreas.' It seems like many people recommend it.

If you were taking 4-5U/ day and doing ok and could take 6-7U/ day and do ok and eat fruit, I don't think that would be a bad thing? I have seen spikes from fruit too but they aren't as long or hard to get rid of as bready carbs for me.

how does your body 'have problems metabolizing carbs'...can i have some sort of source for this?

I think it's a great book, but only as an adjunct to Diabetes Solution. The recipes are by a lady who runs a high end bed and breakfast whose Type I son is a patient of Dr. B's. I'm especially fond of the low carb chili recipe. I made a big pot of it today which I will eat for lunch all this week.

Incidentally, Dr. Bernstein has a webinar and teleconference every month which you might be interested in attending. He talks on the month's topic (last month was statins) for about 15 minutes and then spends the rest of the time answering the questions people have emailed in all month. You can listen to last month's webinar and register for the next one at askdrbernstein.net.

MKSS,

I've been following Dr. B's guidelines for over 3.5 years. I eat tomatoes, onions & balsamic vinegar & figure it into my total daily carbs. Dr. Bernstein mentions that a slice of tomato is ok, but I often eat more than that. Berries are the only fruit that don't send me soaring.

Granted, his recommendations are very low carb, but it's not carb free.

Ditto to what others said about reading Diabetes Solution. Recipes in The Diabetes Diet are pretty blah & the real info is in Diabetes Solution.

We are all here because we have problems metabolizing carbs. We have diabetes. We can compensate with treatments like insulin, but we still have problems.

We all adapt what we learn to our situation. Dr. B has a 6-12-12 plan. If your blood sugar is not well controlled, his plan absolutely works. But that doesn't mean you cannot adapt. Dr. B himself wants us to become smart, to make the right decisions about our health and to act on them. I started Dr. B in 2006. I don't follow 6-12-12, I probably eat 25-100 grams of carbs a day. I eat berries and strawberries, but in measured portions. I also eat tomatoes, onions and even make my own dressing with balsamic vinegar. What I have found over time is that not all carbs are the same. Grains and beans are particularly hard on me, I have a disproportionate blood sugar rise from them and have mostly eliminated them from my diet.

Dr. B suggests that all diabetics only need a few units of insulin/day. But I've not found that true for me. I take 50 units of basal and right now take about 15 units of bolus/day. A lot more than you do. You should take the amount of insulin needed to properly control your blood sugar.

A T1 cannot metabolize carbs, at all, without an external source of insulin, clearly a defect in carbohydrate metabolism.

Many T2's, like me, still make some insulin but it does not work correctly. This is called insulin resistance. Insulin is needed to enable the carbohydrate molecules to pass through the cell wall to the interior or the cell where it can be used for energy. In an insulin resistant individual this process does not work correctly and glucose builds up in the blood stream.

Another function of insulin is to turn excess carbs into fat for later use by the body for energy. In an insulin resistant individual this function works fine and the excess glucose is stored as fat, hence the tendency of many T2's to put on weight. In addition the body tries to rid itself of this glucose by dumping it via the kidneys.

Although carb restriction is a controversial approach to treating diabetes, the basic outlines of the defects in both a T1's and a T2's metabolism is not in doubt. I learned about T2 metabolism at the bloodsugar101 website Here's another detailed explanation of how insulin works in a normal individual as well as in a T2.

Not seeing how following Dr. B is eating 25-100 carbs a day. People adapt some, of course, but eating over three times what he recommends isn't in the ball park. Dr. Bernstein also stresses the importance of keeping carbs & protein consistent day to day. Consistency is key when using insulin, especially for T2's who typically need higher insulin doses than T1's. And, of course his other salient point is keeping insulin doses low through restricted intake.

I don't follow Dr. B 100%. I never claimed to. Dr. B is more than just a 6-12-12 diet.

Dr. B has always been very strict. He has no tolerance for a patient who comes to him, whining about his A1c of 7% and then finding out they are following the ADA diet. You are absolutely correct.

But Dr. B has always been about tight control of your blood sugar, not about a stict adherance to the diet. We can argue about whether my control is tight enough and if it isn't then in Dr. B's view, I need to restrict my carbs. If a patient is restricting carbs sufficient to attain tight control, I don't believe that Dr. B would criticize a patient for eating more carbs that 6-12-12.

And in the world of Dr. B, tight control is actually an A1c < 5%, something that is actually very difficult to achieve and sustain. So I make some choices to balance my life and make it easier.

You said you've been following Dr. B for years, starting in 2006. I assumed that meant you used his dietary recommendatios. Oh yes, he's very strict & everything with him is about precision. No doubt about him being a former engineer:) Having listened to many of his web casts, the frustration in his voice with some questions is clear. Indeed, an A1c under 5% is a feat.

I have come to the same conclusion even if I were cured I would probably continue this way of eating. I consider myself to be carb addicted and the only way to defeat the cravings is to avoid the things that trigger the response. I have also researched it enough to believe that it is healthy.

i thought you meant everyone cant metabolize carbs, not just diabetics...makes sense then :)