Managing the Bernstein eating plan

As I've been slightly critical of Dr B, I would like to make it clear that he is a personal hero, and I believe he is practically the saviour of diabetics. Just as one example he is more or less personally responsible for patient blood glucose testing. The diabetology profession was against it, he only could get a blood test machine because his wife was a doctor (before he qualified as an MD), and he took on the ADA etc and changed their stance. Even if you never carb count, every diabetic with a home blood glucose tester owes a huge debt to Dr Richard Bernstein.

He is also a very lovely man on a personal level. A fantastic human being.

Spiker said:

As I've been slightly critical of Dr B, I would like to make it clear that he is a personal hero, and I believe he is practically the saviour of diabetics. Just as one example he is more or less personally responsible for patient blood glucose testing. The diabetology profession was against it, he only could get a blood test machine because his wife was a doctor (before he qualified as an MD), and he took on the ADA etc and changed their stance. Even if you never carb count, every diabetic with a home blood glucose tester owes a huge debt to Dr Richard Bernstein.

He is also a very lovely man on a personal level. A fantastic human being.

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Great endorsement Spiker. He could not get his papers published so he went back to Medical School at age 45.

He is amazing and outside of the creation of the portable personal glucose meeter his ideas and life style and drug regimes have moved diabetic care out of the dark ages.

He practices what he preaches.

LucySW said:

BTW, somewhat surprised to find that it's Jenny Ruhl's book about the low-carb diet that gives the fantastic presentation of the whole metabolism thing that so impresses me. It's better written than the Blood Sugar 101 book, and perhaps also we know much of what she presents there. I really recommend the Diet 101 book.

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I found the same - but I think she wrote the diet book later, so she probably had better command of the subject, by then...

Just read diet 101 book.... Interesting, but found it mainly applicable to T2's wanting to loose weight.... As a T1 /LADA not wanting to loose weight, I found Dr Bernstein's much more relevant..... But both heavily agree on 'normal' blood sugars being very important, normal being much lower than NHS guidelines.

LucySW said:

I found her explanations gripping and terribly clear.

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I've been following Bernstein's diet for almost a year now. My goal is to eliminate the post meal spikes. I've been able too and reduce my insulin.
The key has been a very low carb diet eating mostly veggies and no fruit except for avocados eggplant tomatoes cucumbers and limited berries

Another key that acts like a vaccination is increasing my lean muscle mass - I still have love handles.

I've seen a reduction in my fasting glucose, decrease in reading glass strength virtual all my pain and numbness in my feet toes and hips are gone.

I also believe that some or a portion of my dying or worn out beta cells have come back.

I can't get a c-peptide test but for the last 10-days I've been experimenting with drinking 35 to 50mg of pure whey protein 1/2 hour before eating a LCHD meal. For 5-days my BG was actually lower than my insulin regiment. Especially my fasting levels a post meal.

I stopped with the regiment partly because Dr. Bernstein recommends not taking oral agents that stimulate beta cells

As soon as I stopped my BG became ad before but I've actuality been using less insulin.

I am think it is obvious that my beta cells were producing insulin.

@runner2009 (Ed?) that is very impressive! Such a shame you can't get a C-peptide test

LucySW said:

I've taken away from that book a new target, that of keeping the BS below her thresholds 1hr after eating, rather than two. Because it's tighter control.

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Lucy that is a really tight target. I think Jenny intends that target to be for T2s with functioning beta cells, and who are also low carbing.

But if you can do it, more power to you!

Really interesting thread guys. I've not been around recently, so I'm just catching up on the interesting stuff.

I'm a huge fan of Bernstein but I know I couldn't stick to his diet so I take the principles and adapt it.

I've come to realise that once the carbs are low, protein becomes a very big deal to BG control. It's a tricky little blighter because it spikes me 5 or 6 hours later when all the rapid acting is used up. For this reason, I stay just out of ketosis. I'm very tiny and 50g carb a day keeps me just out of ketosis. I find a strategically eaten ryvita can help a lot with high protein meals - it's only 7g carb, but gives my body the easy carbs it likes, and is easy to jab for in terms of timing - it seems to help the delayed protein spike that seems to plague me!

I think there is an enormous difference on this between those of us who need bolus and those who don't. For those who don.t, spreading out the carb/protein can help flatten the spikes, but for those who do, we need to be aware of the peak and length of the bolus action and make sure we bolus at the right time, split the dose and/or adjust the timing of the spike by our food combinations.

I'm definitely going to have a go at cutting the protein back a bit though.

Smidge

Hey Lucy!

I don't really count protein, fat or calories, but I aim for around 50g carb in total and spread that over the three meals. I very rarely snack. I'll explain why later.

I tend to have berries and yoghurt for breakfast. Protein and salad for lunch - often a small chicken breast but sometimes ham, a small pork chop or a couple of hard boiled eggs. Tea might be protein (chicken, lamb steak, beef steak or pork) and a large portion of mixed vegetables, a large salad or home made coleslaw; or maybe a small bowl of home made chilli with grated cheese or a home made curry with spiced cauliflower. I follow that with fruit and cream usually - often strawberries; sometimes a peach or large plum depends on how much carb I've already had. Sometimes I'll have home made low-carb ice cream instead. Basically, I have a portion of protein with lunch and tea and spread the carb through all three meals. I could probably cut the protein a bit with my lunch.

The reason I rarely snack is that I find I need a small amount of insulin just for eating, regardless of whether I'm eating carb, protein or fat - there are no free foods! I tend to jab based on the size of the meal and the amount of carb. The bolus only lasts two to three hours so anything after that or that spikes later than that needs another Jab.

If you look at how Bernstein deals with this, he uses short acting insulin instead of rapid acting - it kicks in later and lasts longer. I would find that really inconvenient and wouldn't really fancy my chances of convincing my consultant of the wisdom anyway!

Bernstein's method is a complete package of the right types and quantities of food to match the profiles of specific insulin to match the body's natural mechanism as far as possible. It's far more than a diet.

Smidge

To be honest I am totally freaked out and not sure of what to make of it all. Over a year ago I was diagnosed with Type 1.5 diabetes and spent almost a week in hospital with an A1c of 13.6. I was using about 37 to 40 units of insulin and over time was able to reduced it down to 3 to 6 a day. But as I've reported before if I didn't eat all day or a little my BG would climb to unacceptable heights. When I first read Bernstein's book I threw it down as rubbish - who could live like that. But slowly I evolved and started to follow his regiment.

About a month ago I started following the 50g of whey protein 30-minutes before I ate in the morning and did the same for lunch and dinner. Basically following the protocol in these studies http://clinicaltrials.gov/show/NCT01571622 and a more current one http://www.jewishvoiceny.com/index....ews-for-diabetics&catid=104:health&Itemid=287

Basically if you search 'whey protein gpl-1" or milk protein you will find a number of studies going back 15-years or more testing whether fast acting protein stimulating your guts GLP-1 response reduces BG levels after a high carbohydrate meal. In my case it did and I stopped using insulin for 5-days.

Now I have been following Bernstein's protocol very close for the last 8-months, especially focusing on the LC - less than 26g a day mostly from veggies, and no fruit or processed foods including bread and pasta.

The other thing that I've done is follow his exercise plan, especially pushing my heart rate up - believe me this has taken a lot of work over the year. I've also put on about 15-lbs of muscle. I did this by lifting weights at the house and gym - but not crazily or everyday - and timing my lifting around my 2-daily insulin shots. Being older I was surprised at how much muscle I could build and really believe by timing insulin ( being careful about exercise induced hypos ) acted as a steroid - it is a growth hormone.

About a week ago I stopped the whey proteinase continued on with the LCHF diet ala Bernstein, and over the last 5 days I've used only 3units of insulin.

The crazy thing is my BG level is in the 90s fasting is under 95 and 1 hour out it has not been higher than 106. With the whey protein it runs about 10 points lower.

I recently read about a new insulin combo using a GPL-1 analog mixed with a long acting insulin analog that provided superior BG control without the risk of hypos ( supposedly very expensive ).

My confusion is that I am wondering if I turned some of my beta cells on with the whey, or the fact that I've been so strict with my life style or was it all the macadamia nuts I've been eating for my high fat portion of my meals (-;

I was going to stop using the whey as I was worried that it was artificially simulating my beta cells and reducing the pancreas hepatic glucose production ( google GPL-1 to see how this works for a persons glucose homeostasis by both regulating insulin secretion and glucose production. But my brother pointed out that you are basically drinking milk or dairy protein and you are not taking a analog so don't worry be happy that you found something that works naturally

So I agreed and last night after I had did my aerobic exercises in the afternoon, ate a salad and salmon for dinner, I made a whey protein mixture with cream, coca nibs, coconut shavings and nuts, I went to bed and my BG was 76. I woke up this am and I was at 86.

This sounds crazy but I am confused about what is happening and it should be good news, but as you all know this controlling my BG has taken up a huge psychological toll on me over the last year and being a bit OCD it has been so difficult to manage and take a rest from the daily worry.

Whether this is temporary or not two things I know; I am going to continue following Bernstein's protocol for diet and exercise. I've gotten used to virtually no carbs - as long as there edamame hummus to slather on everything. And two, I am not going to tell my Doctors as they would immediately cut off my prescriptions and my test strips - I can get away with it because ever since I followed Bernstein's diet my spiking has been controlled and my a1c are in the normal range.

Any thoughts?

Sorry @runner2009 I am as confused as you mate. :-(

I would have to say that whatever "local difficulties" you may be having, overall you are in incredible diabetic shape.

@smidge before I went on a pump I would inject Novorapid rather than Humalog for the protein bolus, and inject after the meal - for the reasons you give. Novorapid is slower acting, on paper and in my body anyway. When I could, I used older insulin such as the Actrapid that I started on 18 years ago, because it is slower still.

Why are newer insulins almost always quicker acting than the ones they replace? Because the industry and profession think that the goal of insulin therapy is to try to handle the massive carb loads of a standard modern meal. How many R & D billions spent on that goal, when reducing carbs instead costs next to nothing.

On a pump I do not need to match insulin types to food types any more, because I can bolus a great variety of different shaped insulin-action profiles with the pump.

Runner, Dr Bernstein States that 'beta cells can recover if they are given a rest with the help of injected insulin'.... and BG levels are normalised.

Dr Bernstein also states that he has seen patients 'honeymoon' period go on for ever...... With normalised BG levels.

You have 'normalised' your BG levels...... So here's hoping that your beta cells are recovering.... Only time will tell.

I am really not sure about whey, and have not used it.... It seems artificial / processed.... Against all the 'natural' food that generalises the low carb diet.... Which I kind of like.

Like you, I am following dr Bernstein's 'solution'. Only a few months in, but happy with progress so far (but I do miss fruit!)

In my opinion THE most important thing is to normalise BG levels.... Normalise to Bernstein levels, not NHS levels.
You are doing a great job in keeping your BG levels normalised..... Why change anything whilst you have a working solution.

Spiker said:

Sorry @runner2009 I am as confused as you mate. :-(

I would have to say that whatever "local difficulties" you may be having, overall you are in incredible diabetic shape.

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Oh no Spiker, I've always relied on your vast knowledge about diabetes and I was hoping you could tell me something.

Ian DP said:

Runner, Dr Bernstein States that 'beta cells can recover if they are given a rest with the help of injected insulin'.... and BG levels are normalised.

Dr Bernstein also states that he has seen patients 'honeymoon' period go on for ever...... With normalised BG levels.

You have 'normalised' your BG levels...... So here's hoping that your beta cells are recovering.... Only time will tell.

I am really not sure about whey, and have not used it.... It seems artificial / processed.... Against all the 'natural' food that generalises the low carb diet.... Which I kind of like.

Like you, I am following dr Bernstein's 'solution'. Only a few months in, but happy with progress so far (but I do miss fruit!)

In my opinion THE most important thing is to normalise BG levels.... Normalise to Bernstein levels, not NHS levels.
You are doing a great job in keeping your BG levels normalised..... Why change anything whilst you have a working solution.

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Thx for the words of wisdom. I agree with you about both the normal BG levels to Bernstein vs NHS and that I should not worry, who knows how long it last.

As for fruit, I ate it like crazy before; my favorite food group next to pasta and bread. Little did I know that a diet high in fructose was in actuality a diet high in fat.

Now I don't miss it partly because avocados are a healthy fruit that I can eat.

Good for you on the diet, for me too it came slowly if not reluctantly. But it is the best thing that has happened. I also as I've written befor, not dismiss his focus on more intense exercise.

As I think about it more, I really think the exercise and muscle increase has played a larger portion than I've given credit to.

runner2009 said:

Oh no Spiker, I've always relied on your vast knowledge about diabetes and I was hoping you could tell me something.

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Sorry I must be too tired.

Rereading your post I think you are in better shape honestly than most "non diabetics". No need to worry.