Dr Bernstein and blood sugar levels.

[serenity648]

I have just come across the recommendation by Dr Bernstein to keep blood sugar levels around 83. I assume thats a US figure? it seems to equate to 4.7 in UK terms.

Is that the HbA1c? or fasting? or pre-meal?

Can someone tell me if I am correct that, if it is HbA1c then it is 27 - which seems very low to me. But then, I havent come across this before. I thought that getting under 39 was normal, and anything under about 30 was lower than non-diabetic levels.

any info gratefully received

 

[NoCrbs4Me]

I think he considers an HbA1c below 5% to be normal, but I could be wrong.

I don't agree, simply because the relationship between HbA1c and average blood glucose levels is not exact.

Also, I think it would be impossible for anyone to keep their blood glucose levels around 4.7 mmol/L at all times.

I've read other opinions that damage occurs when your blood glucose is above 7.8 mmol/L for extended amounts of time, so that's what I focus on.

Here's a few pages on blood glucose levels:

http://www.phlaunt.com/diabetes/16422495.php

http://www.phlaunt.com/diabetes/14045621.php

http://www.phlaunt.com/diabetes/43067769.php

 

[kokhongw]

He had observed a long time ago that healthy young adults have blood glucose level right around this magical 83mg/dl...4.7 mmol. And that is where he targets to keep his glucose level with much success using his law of small numbers. Small inputs, small errors. Do follow https://www.facebook.com/Type1Grit/ it is inspirational for me as a T2D to see how kids are able to maintain near normal glucose levels around this seemingly impossible level.

Do search for RD Dikeman's story...of how he stumbled on Dr Bernstein and came to start the Typeonegrit group.
https://myglu.org/articles/our-journey-with-the-low-carb-diet-and-the-manual-artificial-pancreas

Here is a recent snapshot of his son's glucose trend.

https://www.facebook.com/Type1Grit/...6267309865366/878448582313901/?type=3&theater

 

[serenity648]

but I am not a type 1......................sorry, am i being thick?

 

[kokhongw]

but I am not a type 1......................sorry, am i being thick?

He recommends the same dietary approach and glucose targets for both T1D and T2D...because that is what he observed to be the healthy optimal levels.

 

[Fleegle]

Dr B was a type 1 and an early proponent of having LBG to extend his life. He certainly beat the odds - I am not even sure that he isn't still doing so. There is a face book group that follow his works, they are called the rebels I think.

He did not agree with 7.8 but suggested 6.8 was a better 2hour peek number and lived his life that way. He also thought a HBA1C of less than 5 was about right. The rebel group follow his diet recommendations, low carb and a long list of outlawed food. They have really great success similar to here but where he is kind and helpful - the group can be a bit full on IMO.

I think an awful lot of the things we know today in terms of diet were things he bought to the fore if not invented.

 

[kokhongw]

This is his view of maintaining Hba1c @6.3%

 

[Alexandra100]

I think he considers an HbA1c below 5% to be normal, but I could be wrong.

I don't agree, simply because the relationship between HbA1c and average blood glucose levels is not exact.

Also, I think it would be impossible for anyone to keep their blood glucose levels around 4.7 mmol/L at all times.

I've read other opinions that damage occurs when your blood glucose is above 7.8 mmol/L for extended amounts of time, so that's what I focus on.

Here's a few pages on blood glucose levels:

http://www.phlaunt.com/diabetes/16422495.php

http://www.phlaunt.com/diabetes/14045621.php

http://www.phlaunt.com/diabetes/43067769.php

I have just been watching some of Dr Bernstein's videos, and if I have remembered correctly, he believes that 4.7 is a normal random / fasting blood sugar. He certainly believes that diabetics can aspire to absolutely normal bg levels, if they follow his low carb protocol and have suitable care from their doctors. The price is adherence to a strict keto type diet, definitely low carb and high in protein and fat, with the emphasis on protein, alongside regular and vigorous aerobic and resistance exercise.

Normal peoples' bgs also rise after meals, but fall again faster than ours. Even normal people could not expect to have a bg AVERAGE of 4.7. Dr B's ambition for his patients is more demanding than Jenny Ruhl's. She has more sympathy for human frailty and more concern to avoid burnout! Her idea is that diabetic complications can probably mostly be avoided if you keep your 2 hour post prandial bg below 7.8, as you say. However, she also says damage to heart and circulatory system kick in much earlier, at the levels that are considered pre-diabetic. She thinks that most but not all of this damage to the heart can be avoided by keeping bg post prandial levels to under 7.8 at 1 hour and under 6.7 at 2 hours. Finally, she says that an even better target is to keep one's bg below 6.7 always. I have to say I am finding this tough going!

 

[NoCrbs4Me]

Here's a study where they put continuous glucose monitors on 24 young, healthy people:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/

Their mean glucose levels were 89.3 ± 6.2 mg/dl (5 ± .3 mmol/L).
Their highest levels were after breakfast (101–168 mg/dl or 5.6 to 9.3 mmol/L).

 

[Alexandra100]

Dr B was a type 1 and an early proponent of having LBG to extend his life. He certainly beat the odds - I am not even sure that he isn't still doing so. There is a face book group that follow his works, they are called the rebels I think.

He did not agree with 7.8 but suggested 6.8 was a better 2hour peek number and lived his life that way. He also thought a HBA1C of less than 5 was about right. The rebel group follow his diet recommendations, low carb and a long list of outlawed food. They have really great success similar to here but where he is kind and helpful - the group can be a bit full on IMO.

I think an awful lot of the things we know today in terms of diet were things he bought to the fore if not invented.

Yes, Dr Bernstein is very much alive and functioning at 83, as you can see on his site: http://www.diabetes-book.com. As the excellent Jenny Ruhl points out, he is about the only writer on diabetes who is both a patient himself and a physician seeing patients (STILL!)

 

[Fleegle]

Yes, Dr Bernstein is very much alive and functioning at 85, as you can see on his site: http://www.diabetes-book.com. As the excellent Jenny Ruhl points out, he is about the only writer on diabetes who is both a patient himself and a physician seeing patients (STILL!)

Amazing man. I have read bits and bobs of what he has written - amazing.

 

[Alexandra100]

Here's a study where they put continuous glucose monitors on 24 young, healthy people:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/

Their mean glucose levels were 89.3 ± 6.2 mg/dl (5 ± .3 mmol/L).
Their highest levels were after breakfast (101–168 mg/dl or 5.6 to 9.3 mmol/L).

I'd be rapturously happy with 5.3. Some of those young healthy people must have had an amazing breakfast to clock up 9.3. Fried mars bars?

 

[serenity648]

Thank you everyone. One more question - so is 4.7 the target HbA1c number?

 

[kokhongw]

Some of those young healthy people must have had an amazing breakfast to clock up 9.3. Fried mars bars?

Rice pudding perhaps?

 

[Alexandra100]

Amazing man. I have read bits and bobs of what he has written - amazing.

I have ordered his book and am awaiting it impatiently. Meanwhile there are quite a lot of extracts on his site. I gather, though, that his recipes are dire.

 

[Alexandra100]

Rice pudding perhaps?

View attachment 24221

I'd kill for rice pudding - just not myself!

 

[Fleegle]

Thank you everyone. One more question - so is 4.7 the target HbA1c number?

Good question. 4.7 is a healthy FBG number. If you could manage your spikes so that on average you hit 4.7 I think that would be fantastic. As you know because I have seen many of your posts - it isn't one thing though. So as well as 4.7 fbg and pre-meal - a spike as low as possible and certainly not more than 6.8 (for Dr B) would be there too.

 

[serenity648]

I dont think I could get that low for my fasting blood test, as i seem to be one of those people who have a liver dump almost as soon as i open my eyes. But as a pre-meal target its worth the attempt.

 

[kokhongw]

Thank you everyone. One more question - so is 4.7 the target HbA1c number?

4.7 mmol is the baseline glucose level that he believes we should be targeting for or the natural set point...but I am happy with keeping mine around 5.0-5.5 mmol.

 

[NoCrbs4Me]

A "normal" average blood glucose level should result in an HbA1c of close to 4.7%.

However, it may not due to a person being a higher glycator or a lower glycator than average or having a red blood cell turnover rate higher or lower than average.

So, if you are aiming for a "normal" average blood glucose level, the only real way to know how close you are is to use a continuous blood glucose monitor to get your average blood glucose level. A normal average would be 5 ± .3 mmol/L.