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Dr Bernstein Talking About Why Doctors Tell People With Type1 To Run High

dbr10 said:
I believe it was the good doctor. IIRC the meters cost around $600 and could only be obtained by medical professionals. His wife got it for him.
Click to expand...
Here is an extract from Dr B's own account. You can read more, including his struggle to publicise his discoveries, here:
http://www.diabetes-book.com/bernstein-life-with-diabetes/
It is well worth reading, especially as this and many other extracts from his book (though unfortunately not the paragraphs about Lantus) are available free on his site. I bought the book and I have never regretted it.

"During my twenties and thirties, the prime of life for most people, many of my body’s systems began to deteriorate. I had excruciatingly painful kidney stones, a stone in a salivary duct, “frozen” shoulders, a progressive deformity of my feet with impaired sensation, and more. I would point these out to my diabetologist (who was then president of the American Diabetes Association), but I was inevitably told, “Don’t worry, it has nothing to do with your diabetes. You’re doing fine.” But I wasn’t doing fine. I now know that most of these problems are commonplace among those whose diabetes is poorly controlled, but then I was forced to accept my condition as “normal.”

By this time I was married. I had gone to college and trained as an engineer. I had small children, and even though I was not much more than a kid myself, I felt like an old man. I had lost the hair on the lower parts of my legs, a sign that I had developed peripheral vascular disease—a complication of diabetes that can eventually lead to amputation.

During a routine exercise stress test, I was diagnosed with cardiomyopathy, which is a replacement of muscle tissue in the heart with fibrous (scar) tissue—a common cause of heart failure and death among those with type 1 diabetes.

Even though I was “doing fine,” I suffered a host of other complications. My vision deteriorated: I suffered night blindness, microaneurysms (ballooning of the blood vessels in my eyes), macular edema (swelling of the central portion of my retinas), and early cataracts. Just lying in bed caused pain in my thighs, due to a common but rarely diagnosed and barely pronounceable diabetic complication called iliotibial band/tensor fascialata syndrome. Putting on a T-shirt was agonizing because of my frozen shoulders.

I had begun testing my urine for protein and found substantial amounts of it, a sign, I had read, of advanced kidney disease. In those days—the middle and late 1960s—the life expectancy of a type 1 diabetic with proteinuria was five years. Back in engineering school, a classmate had told me how his nondiabetic sister had died of kidney disease. Before her death she had ballooned with retained water, and after I discovered my own proteinuria, I began to have nightmares of blowing up like a balloon.

By 1967 I had these and other diabetic complications and clearly appeared chronically ill and prematurely aged. I had three small children, the oldest only six years old, and with good reason was certain I wouldn’t live to see them grown.

At my father’s suggestion, I started working out daily at a local gym. He thought that if I were to engage in vigorous exercise, I might feel better. Perhaps exercise would help my body help itself. I did feel slightly less depressed about my condition—at least I felt I was doing something—but I couldn’t build muscles or get much stronger.

After two years of pumping iron, I remained a 115-pound weakling, no matter how strenuously I worked out. It was at about this time, in 1969, that my wife, a physician, pointed out to me that I had spent much of my life going into, experiencing, or recovering from hypoglycemia, which is a state of excessively low blood sugar. It was usually accompanied by fatigue and headaches, and was caused by the unpredictable action of the large doses of insulin I was taking to cover my high-carbohydrate diet. During such episodes, I became confused and unruly and snapped at people. These frequent hypoglycemic episodes had taken their toll upon my parents, and were taking their toll upon my wife and children. The strain on my family was clearly becoming untenable.

Suddenly, in October of 1969,my life turned around.

I had been the research director of a company that made equipment for hospital laboratories, but recently I had taken a new job as an officer of a housewares corporation. I was still receiving trade journals from my old field, and one day I opened the latest issue of a publication called Lab World. I came upon an advertisement for a new device to help hospital emergency rooms distinguish between unconscious diabetics and unconscious drunks during the night, when laboratories were closed. Knowing that an unconscious person was a diabetic and not drunk could easily help hospital personnel save his life. What I stumbled upon was an ad for a blood sugar meter that would give a reading in 1 minute, using a single drop of blood.


Since I’d been experiencing many blood sugars that were too low, and since the tests I had been performing on my urine were wholly inadequate (sugar that shows up in the urine is already on its way out of the bloodstream), I figured that if I knew what my blood sugars were, perhaps I could catch and correct my hypoglycemic episodes before they made me disoriented and irrational.

I marveled over the instrument. It had a 4-inch galvanometer with a jeweled bearing, weighed 3 pounds, and cost $650. I tried to order one, but the manufacturer wouldn’t sell it to patients, only to doctors and hospitals.

Fortunately, my wife, as I’ve said, was a physician, so I ordered one in her name. I started to measure my blood sugar about 5 times each day, and soon saw that the levels were on a roller coaster. Engineers are accustomed to solving problems mathematically, but you have to have information to work with. You have to know the mechanics of a problem in order to solve it, and now, for the first time, I was gaining insight into the mechanics and mathematics of my disease. What I learned from my frequent testing was that my own blood sugars swung from lows of under 40 mg/dl to highs of over 400 mg/dl about twice daily. A normal blood sugar level is about 85 mg/dl.* Small wonder I was subject to such vast mood swings."
 
Alexandra100 said:
Here is an extract from Dr B's own account. You can read more, including his struggle to publicise his discoveries, here:
http://www.diabetes-book.com/bernstein-life-with-diabetes/
It is well worth reading, especially as this and many other extracts from his book (though unfortunately not the paragraphs about Lantus) are available free on his site. I bought the book and I have never regretted it.

"During my twenties and thirties, the prime of life for most people, many of my body’s systems began to deteriorate. I had excruciatingly painful kidney stones, a stone in a salivary duct, “frozen” shoulders, a progressive deformity of my feet with impaired sensation, and more. I would point these out to my diabetologist (who was then president of the American Diabetes Association), but I was inevitably told, “Don’t worry, it has nothing to do with your diabetes. You’re doing fine.” But I wasn’t doing fine. I now know that most of these problems are commonplace among those whose diabetes is poorly controlled, but then I was forced to accept my condition as “normal.”

By this time I was married. I had gone to college and trained as an engineer. I had small children, and even though I was not much more than a kid myself, I felt like an old man. I had lost the hair on the lower parts of my legs, a sign that I had developed peripheral vascular disease—a complication of diabetes that can eventually lead to amputation.

During a routine exercise stress test, I was diagnosed with cardiomyopathy, which is a replacement of muscle tissue in the heart with fibrous (scar) tissue—a common cause of heart failure and death among those with type 1 diabetes.

Even though I was “doing fine,” I suffered a host of other complications. My vision deteriorated: I suffered night blindness, microaneurysms (ballooning of the blood vessels in my eyes), macular edema (swelling of the central portion of my retinas), and early cataracts. Just lying in bed caused pain in my thighs, due to a common but rarely diagnosed and barely pronounceable diabetic complication called iliotibial band/tensor fascialata syndrome. Putting on a T-shirt was agonizing because of my frozen shoulders.

I had begun testing my urine for protein and found substantial amounts of it, a sign, I had read, of advanced kidney disease. In those days—the middle and late 1960s—the life expectancy of a type 1 diabetic with proteinuria was five years. Back in engineering school, a classmate had told me how his nondiabetic sister had died of kidney disease. Before her death she had ballooned with retained water, and after I discovered my own proteinuria, I began to have nightmares of blowing up like a balloon.

By 1967 I had these and other diabetic complications and clearly appeared chronically ill and prematurely aged. I had three small children, the oldest only six years old, and with good reason was certain I wouldn’t live to see them grown.

At my father’s suggestion, I started working out daily at a local gym. He thought that if I were to engage in vigorous exercise, I might feel better. Perhaps exercise would help my body help itself. I did feel slightly less depressed about my condition—at least I felt I was doing something—but I couldn’t build muscles or get much stronger.

After two years of pumping iron, I remained a 115-pound weakling, no matter how strenuously I worked out. It was at about this time, in 1969, that my wife, a physician, pointed out to me that I had spent much of my life going into, experiencing, or recovering from hypoglycemia, which is a state of excessively low blood sugar. It was usually accompanied by fatigue and headaches, and was caused by the unpredictable action of the large doses of insulin I was taking to cover my high-carbohydrate diet. During such episodes, I became confused and unruly and snapped at people. These frequent hypoglycemic episodes had taken their toll upon my parents, and were taking their toll upon my wife and children. The strain on my family was clearly becoming untenable.

Suddenly, in October of 1969,my life turned around.

I had been the research director of a company that made equipment for hospital laboratories, but recently I had taken a new job as an officer of a housewares corporation. I was still receiving trade journals from my old field, and one day I opened the latest issue of a publication called Lab World. I came upon an advertisement for a new device to help hospital emergency rooms distinguish between unconscious diabetics and unconscious drunks during the night, when laboratories were closed. Knowing that an unconscious person was a diabetic and not drunk could easily help hospital personnel save his life. What I stumbled upon was an ad for a blood sugar meter that would give a reading in 1 minute, using a single drop of blood.


Since I’d been experiencing many blood sugars that were too low, and since the tests I had been performing on my urine were wholly inadequate (sugar that shows up in the urine is already on its way out of the bloodstream), I figured that if I knew what my blood sugars were, perhaps I could catch and correct my hypoglycemic episodes before they made me disoriented and irrational.

I marveled over the instrument. It had a 4-inch galvanometer with a jeweled bearing, weighed 3 pounds, and cost $650. I tried to order one, but the manufacturer wouldn’t sell it to patients, only to doctors and hospitals.

Fortunately, my wife, as I’ve said, was a physician, so I ordered one in her name. I started to measure my blood sugar about 5 times each day, and soon saw that the levels were on a roller coaster. Engineers are accustomed to solving problems mathematically, but you have to have information to work with. You have to know the mechanics of a problem in order to solve it, and now, for the first time, I was gaining insight into the mechanics and mathematics of my disease. What I learned from my frequent testing was that my own blood sugars swung from lows of under 40 mg/dl to highs of over 400 mg/dl about twice daily. A normal blood sugar level is about 85 mg/dl.* Small wonder I was subject to such vast mood swings."
Click to expand...
Yes, I think it was the engineering background which was crucial to his success. He knew how to analyse and solve problems. His method is to mimic as closely as possible how the body normally regulates blood glucose levels.
 
dbr10 said:
Yes, I think it was the engineering background which was crucial to his success. He knew how to analyse and solve problems. His method is to mimic as closely as possible how the body normally regulates blood glucose levels.
Click to expand...
As is so often the case.. Ivor Cummins, Dave Feldman, Richard Morris and Carl Franklin (the 2 keto dudes) all come from engineering/software/ problem solving backgrounds which I think gives them a whole new perspective on health issues which doctors have been trained out of. It's such a shame that they spend so long being taught parrot fashion "diagnose - prescribe" the curse of modern medicine.. no analytical thought for the most part.
 
bulkbiker said:
As is so often the case.. Ivor Cummins, Dave Feldman, Richard Morris and Carl Franklin (the 2 keto dudes) all come from engineering/software/ problem solving backgrounds which I think gives them a whole new perspective on health issues which doctors have been trained out of. It's such a shame that they spend so long being taught parrot fashion "diagnose - prescribe" the curse of modern medicine.. no analytical thought for the most part.
Click to expand...
You're absolutely right.
 
Yes insulin pathways can get replumbed the wrong way which can take months to years to put right and then so easily disrupted again.
Correct plumbing is essential.
I'm finding mine was replumbed before 6yr old. I've put it right numerous times but so easily disrupted. A lifetime of hard work. Unlike many who experience the opposite. (They rarely have a problem).

I found supplement r-ala very useful. Which again I believe is mentioned in Dr Bernstein's book but a good chemist advised me clearly about r-ala being the useful element and not s-ala. Money well spent.
 
Alexandra100 said:
Here is an extract from Dr B's own account. You can read more, including his struggle to publicise his discoveries, here:
http://www.diabetes-book.com/bernstein-life-with-diabetes/
It is well worth reading, especially as this and many other extracts from his book (though unfortunately not the paragraphs about Lantus) are available free on his site. I bought the book and I have never regretted it.

"During my twenties and thirties, the prime of life for most people, many of my body’s systems began to deteriorate. I had excruciatingly painful kidney stones, a stone in a salivary duct, “frozen” shoulders, a progressive deformity of my feet with impaired sensation, and more. I would point these out to my diabetologist (who was then president of the American Diabetes Association), but I was inevitably told, “Don’t worry, it has nothing to do with your diabetes. You’re doing fine.” But I wasn’t doing fine. I now know that most of these problems are commonplace among those whose diabetes is poorly controlled, but then I was forced to accept my condition as “normal.”

By this time I was married. I had gone to college and trained as an engineer. I had small children, and even though I was not much more than a kid myself, I felt like an old man. I had lost the hair on the lower parts of my legs, a sign that I had developed peripheral vascular disease—a complication of diabetes that can eventually lead to amputation.

During a routine exercise stress test, I was diagnosed with cardiomyopathy, which is a replacement of muscle tissue in the heart with fibrous (scar) tissue—a common cause of heart failure and death among those with type 1 diabetes.

Even though I was “doing fine,” I suffered a host of other complications. My vision deteriorated: I suffered night blindness, microaneurysms (ballooning of the blood vessels in my eyes), macular edema (swelling of the central portion of my retinas), and early cataracts. Just lying in bed caused pain in my thighs, due to a common but rarely diagnosed and barely pronounceable diabetic complication called iliotibial band/tensor fascialata syndrome. Putting on a T-shirt was agonizing because of my frozen shoulders.

I had begun testing my urine for protein and found substantial amounts of it, a sign, I had read, of advanced kidney disease. In those days—the middle and late 1960s—the life expectancy of a type 1 diabetic with proteinuria was five years. Back in engineering school, a classmate had told me how his nondiabetic sister had died of kidney disease. Before her death she had ballooned with retained water, and after I discovered my own proteinuria, I began to have nightmares of blowing up like a balloon.

By 1967 I had these and other diabetic complications and clearly appeared chronically ill and prematurely aged. I had three small children, the oldest only six years old, and with good reason was certain I wouldn’t live to see them grown.

At my father’s suggestion, I started working out daily at a local gym. He thought that if I were to engage in vigorous exercise, I might feel better. Perhaps exercise would help my body help itself. I did feel slightly less depressed about my condition—at least I felt I was doing something—but I couldn’t build muscles or get much stronger.

After two years of pumping iron, I remained a 115-pound weakling, no matter how strenuously I worked out. It was at about this time, in 1969, that my wife, a physician, pointed out to me that I had spent much of my life going into, experiencing, or recovering from hypoglycemia, which is a state of excessively low blood sugar. It was usually accompanied by fatigue and headaches, and was caused by the unpredictable action of the large doses of insulin I was taking to cover my high-carbohydrate diet. During such episodes, I became confused and unruly and snapped at people. These frequent hypoglycemic episodes had taken their toll upon my parents, and were taking their toll upon my wife and children. The strain on my family was clearly becoming untenable.

Suddenly, in October of 1969,my life turned around.

I had been the research director of a company that made equipment for hospital laboratories, but recently I had taken a new job as an officer of a housewares corporation. I was still receiving trade journals from my old field, and one day I opened the latest issue of a publication called Lab World. I came upon an advertisement for a new device to help hospital emergency rooms distinguish between unconscious diabetics and unconscious drunks during the night, when laboratories were closed. Knowing that an unconscious person was a diabetic and not drunk could easily help hospital personnel save his life. What I stumbled upon was an ad for a blood sugar meter that would give a reading in 1 minute, using a single drop of blood.


Since I’d been experiencing many blood sugars that were too low, and since the tests I had been performing on my urine were wholly inadequate (sugar that shows up in the urine is already on its way out of the bloodstream), I figured that if I knew what my blood sugars were, perhaps I could catch and correct my hypoglycemic episodes before they made me disoriented and irrational.

I marveled over the instrument. It had a 4-inch galvanometer with a jeweled bearing, weighed 3 pounds, and cost $650. I tried to order one, but the manufacturer wouldn’t sell it to patients, only to doctors and hospitals.

Fortunately, my wife, as I’ve said, was a physician, so I ordered one in her name. I started to measure my blood sugar about 5 times each day, and soon saw that the levels were on a roller coaster. Engineers are accustomed to solving problems mathematically, but you have to have information to work with. You have to know the mechanics of a problem in order to solve it, and now, for the first time, I was gaining insight into the mechanics and mathematics of my disease. What I learned from my frequent testing was that my own blood sugars swung from lows of under 40 mg/dl to highs of over 400 mg/dl about twice daily. A normal blood sugar level is about 85 mg/dl.* Small wonder I was subject to such vast mood swings."
Click to expand...

I'm glad he got on the right track with physical exercise, if he'd have warmed up properly he'd have probably helped his frozen shoulder, he seems to have developed eye & other problems quickly, but those older insulins must have been harsh, although I'd never advocate a high carb diet as he mentions being on.

I came upon an advertisement for a new device to help hospital emergency rooms distinguish between unconscious diabetics and unconscious drunks during the night, when laboratories were closed. Knowing that an unconscious person was a diabetic and not drunk could easily help hospital personnel save his life.
Click to expand...

I absolutely love that bit :D:D:D couldn't someone invent smelling the unconscious persons breath??:D:D:D but if the worlds diabetic population is 2% and we T1s (the main hypo risk) account for 5% of that 2% benefit from a device coming from a land with no national health care then fair play.:D:D:D

I come from an engineering background for what it's worth, 4 years apprenticeship & 6 years at a tech college, I have a small machine shop in my back garden, currently redundant as my old steam engine customers/model makers have died off over the last few years, but I do have a bit of problem solving experience, which in turn makes me quite confident on my views regarding diet.
 
I am not on insulin, but I saw this on twitter, and it is an interesting issues with him claiming doctors care more about legal risks, then the health of their clients. There have been a few people on this forum with T1 told by their nurces etc that they must increase their A1c.
 
ringi said:
I am not on insulin, but I saw this on twitter, and it is an interesting issues with him claiming doctors care more about legal risks, then the health of their clients. There have been a few people on this forum with T1 told by their nurces etc that they must increase their A1c.
Click to expand...
Seems you're caught by the same dilemma I've found myself in on numerous occasions - see a video interview or article about type 1, especially a low carb/keto one - to post or not to post? Mainly I don't bother because I know some type 1 will object and make it seem like I'm out of my lane :rolleyes:
 
Many T1's are advised to run their levels high. One of the only ways to regain hypo awareness is to let your HbA1C rise.
Considering the dangers involved of being hypoglycaemic and not being aware it stands to reason that such advice is only for the good of the patient.
Bernstein does what he does his way, to suit his lifestyle.
@kev-w is an expert where is diabetes is concerned.
Bernsteins methods make for me being an unhappy T1. I can't live with T1 diabetes if I'm not happy.
This doesn't make Bernstein wrong, sadly the Dr before his name seems to give him more credibility than people like myself and other long term T1 diabetics.
I've never had a doctor tell me to run high. I feel Bernstein made this statement to further build the " diabetic expert wall " around himself.
 
therower said:
I've never had a doctor tell me to run high. I feel Bernstein made this statement to further build the " diabetic expert wall " around himself.
Click to expand...
I think it's an American thing rather than British. There's one case on the Type One Grit forum at the moment where the parents have been reported to Child Services for having their child on low carb - and its not the first time apparently.
 
@Mel dCP has had it in the UK.

The child services case if it the same one that has been on twitter looks like it was two sides of the family at war with each other and the courts went with what a doctor said about children needing lots of carbs.
 
ringi said:
I am not on insulin, but I saw this on twitter, and it is an interesting issues with him claiming doctors care more about legal risks, then the health of their clients. There have been a few people on this forum with T1 told by their nurces etc that they must increase their A1c.
Click to expand...

OK? & I was one of them.. My answer to a question of "what is your ideal HbA1c?" By a DSN. Was as close to non D as possible under the circumstances...

Don't get me wrong, I omit from my diet the "usual suspects," I do adopt a lower C aproach, but that is down to my personal lifestyle & what I'm working whith regarding insulin timing/working profile & such like.. (& I'm happy for a bit of "lettuce leaf banter shared twix T1s.)
I've no right as a "brother T1" to allow @kev-w 's personal regime to be scrutinised or questioned.. ;) (No probs with the ducks bro.)

My only critique is that this subject should have been brought up in another sub section.. What do you think of a move @ringi ?
 
Great idea @Jaylee .
The term low carb is taking over the thread.
The thread started as a T1 topic with no mention of carbs but appears to have been hijacked.
 
Jaylee said:
I've no right as a "brother T1" to allow @kev-w 's personal regime to be scrutinised or questioned
Click to expand...
I really don't think anyone has done that.. and having just re read the thread I think it is rather that @kev-w has questioned other people's regimes in a not very supportive way.
 
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