Tag Archives: dr. bernstein

Why Dr. Bernstein is an American Hero and Why Doctors Should Be Curious About Him

My colleague at Diabetes Daily, Maria Muccioli, Ph.D., wrote an excellent and in-depth coverage of a remarkable study on very low-carb diets for treating type 1 diabetes in children.

The study found that a group of type 1 diabetic children following a very low-carb diet à la Dr. Bernstein style were not only experiencing normal blood glucose levels (this is nearly unheard of in type 1 diabetes) but also growing well (a top concern as macronutrient intake of carbs is widely believed to be essential for growth in children).

The researchers of the study looked at children from a Facebook group called Type1Grit. This group consists of adults with type 1 diabetes and parents of children with type 1 diabetes who all follow Dr. Bernstein’s regimen. This regimen includes very low-carbohydrate intake but so much more–put just any type 1 diabetic on a very low-carb eating plan, and I promise you’ll likely not get the results you are hoping for–though if you pay close attention to blood sugars you may notice some interesting things regarding the statistical range of error after giving smaller amounts of insulin. It’s about more than low-carb eating. Low-carb is essential to the plan but to do well, there are more things to do and understand. One must understand how to use and adjust insulin properly, understand how different physical activity impacts blood sugars, and so on. The Type1Grit group does so well because they utilize Dr. Bernstein’s decades’ long expertise to guide them (which is all in his book) and like any good support group, they help each other stay focused, informed, and motivated.

Some people on social media have voiced strong opinions against the group due to some of their outspoken members. It is my hope that we focus on content over delivery when it comes to important matters. After all, if fellow thinkers had rejected Issac Newton’s findings simply because he was a jerk (and according to the book I’m reading my kids about him he was) wouldn’t that be a shame? Personally, I strive to be gentle with others because I am quite sensitive. However, I also try not to put my feelings above critical thinking, and I think that serves me well. I also hope that the communication of a few doesn’t cause some to dismiss the whole group or worse–a promising idea. That said, I have not personally observed anyone from that group being rude to others, though some have been quite open and blunt with their opinions and I have observed a very strong response to that, in general. I do not consider an opinion shared in a straightforward manner to be rude.

My Personal Story Following Dr. Bernstein’s Advice

I have followed a loose version of Dr. Bernstein’s protocol for about a decade, further lowering carbs and adding in more of his advice gradually over the years (I now follow his advice very closely). His logic struck me like lightning when I read his book, Dr. Bernstein’s Diabetes Solution. In particular, I was deeply moved by a line that said something about how people with type 1 diabetes “deserve normal blood sugars”. Dr. Bernstein’s protocol includes the use of Regular insulin to cover high protein meals versus faster analog insulin such as Humalog or Novolog. In fact, after using a CGM (continuous glucose monitor) for the first time recently, I quickly saw how my Humalog was a bit too quick and potent at mealtime and then a bit too short hours afterward, so I bought Novolin R at Walmart for $24 and have improved my blood sugar levels. This is to stress how following Dr. Bernstein’s protocol is about more than just reducing carbohydrate intake.

Many years ago, I found immense value in attempting just a little bit of Dr. Bernstein’s advice. Small changes like lowering my carbohydrates and understanding how to use my insulin better led my A1c to drop from 8-9% down to 6%. Before this, just covering high amounts of carbohydrates with insulin had mostly succeeded in making me fat, tired, depressed, and anxious (oh and with protein spilling into my urine as an 18-year-old in her “prime” of life). You have to understand how terrible this was for me–I was a bright-eyed kid who was intelligent, hopeful, hardworking, patient, and super determined. In a few short years, diabetes messed with my potential–I didn’t recognize myself anymore. It’s particularly sad to spend years recovering as a young adult when you’re supposed to be at peak performance and potential due to your youth and energy.

Dr. Bernstein, who many dare call a “quack” or “nutjob” saved my life just as he saved his own. My A1c hasn’t touched 6% in many years. I have a wonderful husband. We have twins who are about to turn 9. I’m still trying to reverse some of the consequences of very high blood sugars from my first 10-12 years with diabetes. What if I didn’t have to?

What Actually Does More Harm?

People tell me that eating low-carb will hurt my cognitive abilities. Do they know that studies indicate that typically managed type 1 diabetes may do that, anyway? Type 1 diabetes (with the average management of 8.2% A1c in the U.S.) has been shown to possibly lower intelligence and negatively affect memory and speed. Low-carb in the long-term may hurt my cognitive abilities (I haven’t seen anything to indicate this possibility though) but what if it just takes the place of what high blood sugars would have done to my cognition? And what if low-carb additionally helps protect my cardiovascular health and my kidneys and my eyes–oh and allow me to have healthy children! Do you know how fortunate I am that I turned things around when I did? I have children because of the information that turned my health around just in the nick-of-time. I can’t begin to describe the level of rage I might have had I never had children yet discovered that Dr. Bernstein has been trying to tell the world about his successful method for decades.

Where is Our Curiosity?

If you find Dr. Bernstein followers as angry or overly-passionate, this may help explain why: Unnecessary suffering is a tragedy. We’re in a country whose founders had been curious and open to acknowledging ideas that are worthy, pushing those ideas to the top where they can be put to the test and then accepted as the best ideas because they can create the best outcomes. This is the great thing about Western Civilization. The embracing of objective principles which allow the best ideas to rise because even if they come from someone we can’t stand, we know that ideas, critical thinking, and truth reign over all else and push us towards progress. Dr. Bernstein’s protocol isn’t an expensive training center and it’s not just for the elite of the world. He thrives using a cheap insulin in the same country where people die because they don’t know they can change their dietary habits and purchase cheap over-the-counter insulin in most states and survive.

From an economic and financial viewpoint, Bernstein’s protocol is also a stunning success. I don’t use an insulin pump or a CGM (I only got to test one out) and yet I can achieve my glycemic targets. I don’t need any apps, certified diabetes educators, or expensive technology. I don’t anxiously await a closed-loop hybrid insulin pump system because I don’t need it. I put all my energy into my simple but effective daily lifestyle. Providers who want to see healthier patients, please read Bernstein’s book. Your lower income patients may not want to follow the regimen in part or entirely but those who are willing deserve to know how to thrive with diabetes despite being poor or lower middle class, like me. I give myself excellent care for cheap–doesn’t that peak your interest?

People are justifiably angry over insulin prices but what about the medical community’s unwillingness to be curious about one doctor’s personal plan to keep himself at peak health and fitness well into his 80s? Without curiosity, what on earth then drives a doctor to investigate the issues in each patient as well as find the proper and least harmful solution? I tell my doctor how I managed a huge drop in A1c for the first time in my life and he has no questions regarding how I did it? I read doctor responses to research that shows a teeny tiny improvement in A1c and now they think “this shows wonderful promise and we should look into it further!”? I basically told my doctor I might have just saved my own life and drastically improved my quality of life, and he’s like “meh”. I told another how I did it and he said, “good for you.” Yes, good for me, but what about some of your patients who are as I was, struggling to get a halfway decent hold on their blood sugar and suffering? What about them? Don’t you have an obligation to check this out? This gives my doctor less work, by the way! For a decade now my doctor does nothing to manage my diabetes–he just orders labs. Aren’t doctors wanting more patients that can manage their blood sugars and don’t need them so desperately at all hours?

It Takes “Too Much Discipline” or “Restraint”

Nothing terrible ever happened by being disciplined. Think of all the amazing people out there and from history–what could they have accomplished without discipline? Probably nothing but a few moments of greatness. Discipline encompasses you within a realm of potential greatness. And if you create a system, discipline isn’t a show of willpower as much as you just loyally following your regular routine.

Much research backs up the potential of the ability to defer gratification. Who is more likely to become successful? The person who can restrict themselves from their impulses and short-lived desires, right? Let me put it this way: who would you rather marry? Someone who can keep their impulses in check or someone who can’t? Or who would you rather be? Someone who doesn’t overeat or someone who regularly does? I remember having hearts in my eyes when my husband told me “I never overeat”. I have long struggled with overeating, and when he said this, I was impressed by him and thought, “wow, I want to be like that.” I believe this is the empowered response. I could have given the common humorous response of “ugh, you make me sick” but where would that have gotten me? Instead, I tried to learn from my husband and improve myself.

I also think the healthy response is to admire someone like Dr. Bernstein for what he has accomplished against great odds. Dr. Bernstein is respected by so many because he created a well-functioning system to get himself thriving and generously shared his findings with others. In fact, as an engineer, he became an endocrinologist so that he could help others after he figured out how to save himself. He should be regarded as an American hero, whether you want to do what he recommends or not.

I believe in freedom and personal rights. I’m an immigrant who is incredibly happy to live in the U.S. Growing up when I found something challenging and I didn’t want to face it, my dad would say “Are you an American or an American’t?” I would often roll my eyes but, yes, I’m an American and believe I have the power to set my mind to improve myself if I want and I’m grateful for those who have set their minds to things and laid out paths before me. Thank you, Dr. Bernstein. I may never reach your astounding level of discipline but what I have been able to achieve with your advice has been most valuable to me and my family and I am forever grateful.

En fin, I’m certainly not saying you should do what he does or what I do. And I can respect wherever you are on your journey. I’m saying that Dr. Bernstein’s method has shown undeniably incredible potential and results and the general lack of curiosity and investigation on behalf of the global medical community makes absolutely no sense to me. There are now thousands of people doing it and doing it well.

Newton supposedly struggled with his ego and an inability to face criticism or questioning during his lifetime. Let’s have his overwhelming curiosity without the pride, his determination to dig and experiment properly without his emotionally unstable and anti-social ways.

I will leave you with one more thought:

Just a little bit less damage sustained is a great deal to the person enduring it, especially when they still have many decades ahead of them.

When Diabetes News Overwhelms You

I write about 6 articles a week for Diabetes Daily.

Most of what I do is share information regarding diabetes news and a great deal of that is comprised of studies that effectively help us learn more about the effects of diabetes on our bodies.

If it depresses or overwhelms you to read this types of news, believe me, I completely understand. I felt sick for the first few months of doing this kind of writing because every piece of what seemed like bad news gave me a strong negative physical reaction. I quickly realized I needed to do two things: compartmentalize and use actions to attack my fears.

What many of these studies iterated to me was that I needed to find a way to avoid as many high blood sugars as I could. One of the reasons I feel so strongly about this is that I’ve already dealt with the negative effects of prolonged high blood sugars and if I had been diagnosed last year, I’d likely feel a little less motivated to employ some serious interventions. Yet, maybe not, who knows.

Time and too many high blood sugars has taken it’s toll and I must fight to win back as much health as is humanly possible. I’m stubborn, as I’ve said before many times, and I want not just so-so health, but I want to be as healthy as a healthy person without diabetes. Will I achieve that? Probably not to the degree I’d like but I believe in striving for the best possible outcome, so that when I fall a little short, I’ll still be in a great place and proud of my efforts.

So how did I compartmentalize? Well, I started to read these harrowing news stories almost as if I was outside of my body and I didn’t personalize anything of the data for myself. For example, if I was looking at how many people with type 1 diabetes suffer kidney damage after a certain number of years with type 1, I did not allow myself to apply that to my many years with type 1. I basically pretended I didn’t have diabetes while I read and wrote about this. It sounds robotic, and it certainly kind of is, but my sanity is crucial to my overall health so I needed to get through the information, log it into my brain, and keep it there as pieces of useful data available to guide or influence my future decisions.

Now for the real important bit–attacking fears with action. The best way I know of to feel more in control and more motivated about a situation is to act on it. Action needs to be fueled by knowledge and caution, of course, but action is THE catalyst for any positive outcome we might enjoy. No one ever lost weight by thinking about it or wishing for it.

Here’s the dialogue that plays out in my brain:

What is my fear? That i’ll develop any number of complications.

What causes diabetes complications? If I’m going to generalize and I am, it’s high blood sugars both acute and prolonged over time.

So what should I do to manage my fear? Avoid high blood sugars.

How do I avoid high blood sugars? For about 8.5 years i’ve written about Dr. Bernstein and his low carb recommendations for people with type 1 diabetes. I’ve lowered my carbs gradually over the last 13 years and seen much fewer highs as a result. I’ve continued my efforts to the point of following a very low carb diet in a more consistent manner and i’ve seen even fewer episodes of high blood sugar and fewer episodes of low blood sugar, too. Also, the catastrophic highs and lows are nearly non-existent.

Fewer highs and lows have literally been the remedy to my fears. Now, I still have fears about certain aspects of this condition and I get tired of living with diabetes, but just like any human, I can’t expect to live without fear, I can only hope to manage it in a way that lets me accomplish what I want and be happy with my life.

Each time I read or write about diabetes, I keep it impersonal but I save the information away to use when I need motivation or information with which to make a decision.

I hope that you, too can consider new information carefully versus letting it alienate you from something that might help. Don’t be afraid to talk to a healthcare professional about what you read, too. Some studies are not as reliable as they seem. Others are funded by the very companies that stand to make a profit.

Remain skeptical but don’t turn away from information–it might be just what you need.

What’s The Best A1c?

Covered in coffee and crayons but, here's the Proof
Covered in coffee and crayons but, here’s the Proof

 

I loved how on DSMA the other night, everyone agreed that the best A1c level varied from person to person.  It’s true.  There are so many variables in our lives that differ from others. 

Some people don’t feel when their low.  Some do.  Should they run their numbers the same?  What about a one year old versus a 25 year old?  Some of us are able to test more frequently than others, some have a CGMS and some don’t, some have complications and some don’t, and then there are personal preferences and comfort levels.

My goal for a low A1c seemed odd last night because of how low it is.  I aim to be between 4.5 and 5.  I truly understand why someone wouldn’t feel comfortable running numbers that low.  My goal is what it is because I always feel my lows (starting at 65), I stay at home with the kids all day (so it’s relatively easier for me to test and eat), and because I’ve heard that a non-diabetic usually has an A1c that starts with 4%.  Oh and because I don’t feel well if I run a little higher.  And if I don’t feel well, I’ll get depressed, and if I get depressed, every aspect of my life and my family’s suffers.

I’ve heard other data on what a normal A1c is and so the discrepancy is something I wonder about from time to time.  Is it better to have an A1c of 4.8 than 5.5?  I don’t know.  But, since most of the data I’ve read puts most A1c’s at a 4.-something, then that’s what I go for-providing it’s safe for me.  I’m grateful that I feel my lows.  I’m grateful that I don’t have a hectic lifestyle at the moment (even If I sometimes yearn for more excitement).  And I hope every day that having a low A1c will give me chances closer to that of someone without diabetes. 

Someone once emailed me saying my A1c was “rude to disclose” because it “made people feel bad about themselves”.  First of all, I’m sorry this person felt bad.  Secondly, we have a choice whether we let someone else’s results make us feel bad or not.  Thirdly, I’m well acquainted with my own past A1c’s of 8, 9, 10, and 11% and I have disclosed that, too.  We’re all on a journey to better and maintain health.  If I get a complication and you don’t, I should be happy for you and forgiving (not critical) of myself. 

Someone has also said I must be lying (so above is the picture of my latest lab results).  Luckily the majority of people in the DOC believe one another’s posted results, and that’s nice.

Anyway, the whole truth is, my feet are feeling funny lately…and it may not be diabetes related, but it may be and I’m scared to death.  I’ve limped a lot for the past 7 months and can only work out for about half a month and then I’m sidelined again.  So until I can see a doctor (appointment is in April), I’m going to aim low, try to avoid lows, keep standard deviation low, and <sigh> hope for the best.

The Science Behind Type 1 Diabetes and Weight Gain

 

It’s understandable that any community would prefer to say, “To each his own” when it comes to personal choices like eating preferences.  So I frequently hear diabetics say that they can eat whatever they want and advocate for other diabetics being able to do the same-as long as each person is successfully able to manage their blood sugars.

And this makes sense to me.  It’s true that every person’s diabetes varies from the next. 

Something that also makes sense to me is what Dr. Bernstein calls “The Law of Small Numbers”.

It’s something I figured out before hearing about Dr. Bernstein.  Since a certain percentage of insulin going in us isn’t being absorbed each time, there is a varying error margin.  The more insulin we need to give, the higher the error margin. 

For example when I lost weight, my blood sugars improved, in part because my insulin resistance was lower and I then needed less insulin than before.  When I changed my eating to lower carb intake, I again noticed better blood sugars because I took less insulin and therefore saw a lower margin of error every time insulin was given.  This lower margin of error is nothing short of miraculous on blood sugars.

If I eat a bowl of pasta, I’m personally, going to give about 7 units of insulin.  A certain percentage of this insulin will inevitably not be absorbed efficiently.  This means that after eating, I will most likely have to correct blood sugar with insulin or some sugar. 

If I eat a steak, I give about 1/2 a unit of insulin.  Again, a certain percentage of this insulin will not be absorbed efficiently.  An “X” percentage of 1/2 a unit of insulin is surely to be less than the same “X” percentage of 7 units right?  This means that with the steak, my chances for having a low or high after eating are minimized AND it means that if I do get a low or a high, the low won’t be very low and the high won’t be very high.  So I’m more likely to stay within a better range. 

This is why I don’t feel that a pump necessarily equals better blood sugar control.  If someone is eating all the carbs they want and just correcting with boluses and sugar as needed, then the likelihood for a higher A1c goes up-because of “the law of small numbers”.   

My lowest A1c test result was over 2 years ago and was a 4.6.  My doctor automatically assumed I was having too many lows and should let my “blood sugars run higher”.  “Really? Higher than yours get to be?”, I thought.   I had to explain to him that I had fewer lows during the time reflected in that A1c test than I had during the time my A1c was a 6.8.  I just had more consistent numbers.

The months prior to that 4.6, I was experimenting with low carb eating to see how my A1c would turn out.  Not only did I lose weight, but the greatest thing was how my blood sugars stayed even keel.  The swinging blood sugars stopped, as did my swinging moods.  Of course, there are still plenty of things that affect blood sugars but, for me, eating low carb made post meal 40’s turn into 70’s and 250’s turn into 150’s. 

It’s so much easier to get a 150 down to 100 than it is to get a 250 down to a 100.  Plus, correcting for a 250 means again that because you’re giving more insulin than if you were 150, there is a higher margin of error and a high risk that in a few hours you’ll need more insulin or more sugar. 

This brings me to my next point.  For type 1 diabetics eating a lot of carbs, weight management becomes difficult.  Most of the thin type 1 diabetics I’ve known of are either adults eating low carb diets or children who are still growing. 

How many type 1 diabetic children don’t start struggling with some weight gain once they turn 18 or 21?  Of course there are exceptions to every rule but, for the most part, I’d say that a way to minimize weight gain in type 1 diabetic adults would be to eat fewer carbohydrates.  The yo-yo on blood sugars that a higher margin of error exacerbates translates to more insulin and more sugar correcting.  This directly translates into weight gain. 

I know it’s not what you want to hear.  After all, we diabetics can eat anything we like and just cover with insulin!  Sure…but, I don’t know about you, I like to be thin.  It means less insulin resistance and better glucose numbers and an easier time exercising.  It also means there is less stress on the body in general.  Such as our feet.  What about knees?  10 pounds of weight loss equals 40 pounds of pressure off of your knees.  So the benefits continue on and on.

I’m making a case here because I wish someone had made a case to me when I was in High School.  I was on the Varsity Soccer Team and so I exercised at least 2-3 hours a day.  I was heavier than all the other girls on the team even though I ate less.  Not fair!  I could have been spared a lot of heartache and frustration. 

Back to today.  Currently, major financial restraints have me eating more carbs than I’d like to (more brown rice, less meat) and my daughter being allergic to eggs means I can no longer rely on an egg’s cheap, low carb, and perfect nutrition.  It’s probably why I’m not losing weight right now.  I eat 40% more carbs than I did 2 years ago.

But before all this, here is what used to work great for me:

Breakfast:  One or two eggs

Lunch:  Chicken salad or tuna

Dinner:  chicken/beef/fish and a side of veggies

Snacks:  Beef jerky, raw veggies, nuts, dark chocolate

Several times a week:  small servings of lentils or beans, fruit, green vegetable juice, Ezekiel Sprouted Grain bread.  (I try to make these my low correcting foods if I’m not too low)

Drinks:  Water, herbal teas, coffee (diet soda would work only it tends to make me really hungry)

I admit it isn’t easy or very cheap to eat this way (especially not cheap if buying all this in the organic section).  You get used to it though and dropping pounds and feeling healthier makes it more than worthwhile.  I’ll say it again.  It’s not easy.  You may feel something is missing from your diet.  Yet, if you are having trouble losing weight or if you are trying for a lower A1c, this is the best way I know of to do both.

I share this info because it proved invaluable to me and my health.  You take it or leave it or take a little of it, whatever you like. 

Salud!

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