Bernstein and the Carb Conundrum…no that’s not the latest Berenstein Bears book…
Most people with diabetes have a relationship with carbohydrates. Let’s face it, as far as food goes, carbs are where the impact occurs. No one ever ended up with a BG of 300 because of chicken. But, living without any carbohydrates is damn near impossible, not to mention boring, and, by many accounts, unhealthy, right? We’re told from a young age that whole grains and fruits and vegetables contain healthy carbohydrates that everyone needs to keep their body strong.
Well, there’s at least one doctor who strongly disagrees, and he’s got the street cred to back it up. His name is Dr. Richard Bernstein, and he also has Type 1 diabetes. Dr. B was diagnosed in 1946 with T1DM at the age of 12. Though he claims to have diligently worked at managing his disease, the tools to do so were simply not available in that day and age, and Dr. Bernstein began to suffer from diabetic complications in his early thirties. In 1969, everything changed when Dr. Bernstein allegedly became the first person to purchase hospital-grade blood glucose monitor for home use. In those days, a meter cost $650 dollars, took a full minute for results, and required a drop of blood that was surely larger than the mere pin prick that gets it done today.
Bernstein was obsessed with the newfound data, and began tweaking and changing his diabetes management. He added doses, changed his diet, and logged like a maniac. Dr. Bernstein was so meticulous that within a year, he was able achieve normal blood sugars “around the clock” and claims that his diabetic complications began to reverse. In a quote from his website, he also notes that (my personal favorite) “his friends commented that his complexion was no longer gray…” (well that’s a side effect I hadn’t heard of yet!)
At that time, Dr. Bernstein wasn’t even a doctor yet. It wouldn’t be until 1977 at the age of 45 (wowza!) that Doc B actually went to medical school to become an endocrinologist. He was so amazed at the results he had achieved that he felt compelled to reach the masses with his message. He knew he needed the medical background to assert that kind of influence, so he went ahead and became a doctor (normal hobby to just “pick up”). After successfully treating hundreds of patients, Doctor Bernstein published The Diabetes Solution, which is his comprehensive guide to his philosophies on diabetes management.
So what’s his secret? How does an insulin dependent, Type 1 diabetic achieve near normal numbers most of the time? It mostly revolves around Dr. Bernstein’s Law of Small Numbers. Dr. Bernstein believes that large amounts of carbs and large doses of insulin result in large variations of blood sugars. In contrast, small numbers of insulin and carb result in small errors. In order to stick to only small doses of insulin, Dr. Bernstein abides by and prescribes to his patients an extremely low-carbohydrate diet. I’m talking really low. 30 grams a day. 42 if you are up for longer than 16 hours (meals must be 4 hours apart). 30 grams of carb? I had that much for breakfast in my egg-white-turkey-sausage-on-whole wheat concoction this morning….30 grams in the whole day??!?
Upon further research, I found out that this is exactly in line with the Atkins diet, which of course practically took over American supermarkets a few years ago and almost forced Dunkin Donuts out of business. Atkins recommended a mere 20 carbs a day for the first two weeks – and then slowly phases up to 40-ish for maintenance. I always thought that I ate pretty low carb, but the serving the tomato soup I had at lunch would have destroyed this diet.
Reading up on this has me curious though – I certainly know when my total daily insulin levels go up, it reflects wide swings in my blood sugars. I usually run about 40 total units a day, and if I start to creep towards 50, it generally means there were some carb-bombs involved that caused some control issues. In addition, the wider swings in blood sugars that I have, the harder it is to normalize. We’ve all had those days where one high forces a large insulin dose from which you end up low and then you eat to get it back up and so on and so forth. Barring outside issues like being sick or stressed, only carbohydrate causes that kind of variation.
The issue I have with the Bernstein diet is that I don’t think that’s’ a feasible way of living long term without compromising overall life enjoyment. No birthday cake on my own birthday? No way! No brewskis during the Padre game? Boring! No doubt there are people in full belief of the power of this diet – all you have to do is check his website for testimonials of Type 1s and 2s who’s lives have drastically changed with this diet, I just don’t know if I could maintain it for a lifetime as Dr. Bernstein recommends.
I am curious enough though to try this out for a couple of days – I’m wondering if any of you out there have tried a similar diet? What’s the best number of carbs for glucose control? Is there a magic number? Is it really about daily totals or more about meal totals? I plan on getting a little more info over the weekend and then hitting the grocery store! Updates to follow next week!
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Comments
I read his book a little more then 10 years ago, when I was on MDI (instead of the pump I use now). It did make a difference, but I just couldn’t sustain it. I ended up losing a lot of weight, mostly because I didn’t know what to eat and so simply stopped eating very much.
I do think for most people out there, the take-away from the book should be to limit the number of carbs at any one sitting as much as possible. Large, carb-infested meals are impossible for me to control, but the same carb amount spread throughout the day is doable.
RG - that approach to carbs makes sense - it makes me sad that you stopped eating so much for while b/c there was nothing to eat! I have been eating very low-carb today (I am at a total of 18.5 grams!) BUT I am not seeing much of a difference b/c I also have a cold….running quite a few highs right now - YUCK. Thanks for the feedback on the book, glad to hear from someone who has actually tried it. Is the book worth reading for other information?
Good question Sara - I did not see anything in my internet research, I wonder if the book itself addresses that?
Ah, sorry, I write comments and then forget about them unless I get email reminders. The book is definitely worth reading - I skimmed through it again a year ago and really liked his explanations on exercise and how it affects your body.
18.5g of carbs a day? That’s amazing! I tried it my junior year of college, and since I can’t cook very well I survived on mostly string cheese (sad but true). I will say that controlling my sugars became remarkably easy once I cut out the carbs.
Alexis,
I read the Diabetes Solution a few years back and it was very helpful to me. I still use some of the principals from the book in my daily routine.
But as far as living his super strict lifestyle for the rest of my life, well…I dunno. There’s just too much good sushi out there if you know what I mean. Some of us on tudiabetes.com call him “Crazy Bernie” because he’s so adamant about his lifestyle.
I did find that once my body got used to lower carb intake, it became a lot harder to control the occasional big carb meal. I really try to avoid heavy carb meals unless I worked out beforehand, which helps a lot too.
Is there any mention of how the high levels of protein effect the kidneys long term?