Type 1s: Bernstein for T1

[Clivethedrive]

I bought his book... twice lol

Everything he says makes very much sense. I feel like he took a path I would have ended up taking had he not already done so (we are both engineers, both T1D, and i have though many times that had i been diagnosed sooner i would have likely tried to get into med school - which he did)

I don't follow his diet, but a lighter version of my own. My main goal is 'keep carbs as low as possible for as long as possible -without it ruining my life' because like many his diet is very strict.

I believe he is legit, and knows what he is talking about - his age is good factor, and the fact that he has recovered from his complications help build trust. It just makes sense to take advice on diabetes from a doctor who has it.

Nicely put @Diamattic,I agree Dr Bernstein is a genuine man who has taken diabetes and knows how to treat and control it

 

[Wurst]

I followed his strict low carb diet high fat + high exercise approach for > 3 years almost from diagnosis. Due to hereditary cholesterol problems I stopped the diet over 1.5 years ago but kept up the exercise regime. I'm still able maintain tight blood sugar control even with addition of higher carb meals/ treats and my diet is much more pleasant now.

His recommendations / explanations in his book really helped me when I was first diagnosed, but I have found my own way now......

 

[Pinkorchid]

Bernstein DID have complications. He talks openly about them in his publications.
He is left with permanent deformities in his feet as a result.
I recall him mentioning kidney and sight problems, but it is 3 years since I read the book.
Since adopting his very low carb, exercise and strict glucose control regime, he found all his other complications have improved to the extent he is symptom free in his 80s, and for the last few decades.

His perspective is that by keeping the blood glucose so low, the body can heal itself.

This is all discussed in his book Diabetes Solution.

I did not know about his complications and good for him in reversing them. I do however think it is wrong when sometimes on the forum it is said to newbies that the LCHF diet can prevent complications and it gives the wrong impression because no one can predict that as it is not known who will or will not have them whatever they do.

 

[AtkinsMo]

While ever virtually all medical research is funded or conducted by pharmaceutical companies, there will never be large scale research into methods that reduce the requirement for medication. Following Dr Bernstein's approach every diabetic would require less insulin, lower sales for pharmaceutical companies, lower profits. Who exactly would fund this research?

Dr Bernstein is an inspirational man and his honesty and integrity shine through. At his age, he cannot still 'need' to be working, purely for financial gain. I listen to his webinars often and he is a genuine, caring and committed individual.

A very low carbohydrate diet can be very enjoyable and satisfying, you just need to work at it.

Even if you do not want to go to the extremes of the tight control that he achieves and the discipline that he encourages, his 'Law of Small Numbers' makes perfect sense, as he puts it, industrial quantities of insulin are impossible to predict and control. My father was diagnosed in the late thirties, I was born in the early 50s and I was definitely brought up in a low carb / controlled carb household, I just didn't recognise it as such at the time. Strict carb restriction was the norm for diabetics before the guidelines changes towards whole grain etc. I remember my father would have none of it when his diabetic clinic told him he should have umpteen servings of carbohydrate a day.

We have a few courageous doctors, willing to challenge the status quo, Bernstein is one of them, along with Noakes, Mulhotra, Unwin and Kendrick. We should not underestimate their endeavours.

 

[azure]

I think there is a big difference between controlling your carb intake and not just eating what you want and having lots of insuoin, versus Dr B's approach. The level of carbs he recommens is miniscule. I simply don't believe that good control can't be achieved with a moderate amount of carbs. So, while excessive carb consumption might be unwise for Type 1s, I don't believe such tiny amounts of carbs (and food in general - one slice of tomato on your salad, anyone?) is necessary.

You mention the older diets for Type 1s (I'm presuming your dad was a Type 1 hence your comment) and I do think they are certainly worth looking at, and I'd be interested in a study comparing those with excessive carb consumption as recommended today. But even then, decades ago, the recommended carb levels, although restricted, were nothing like as low as Dr B's. They tended to be around 20-30% of total calories. So for a woman eating 2000 per day, around 100g-170g very roughly, and more for a man.

So way more than 30g per day.

As well as eating a moderate level of carbs, I think the judicious use of insulin is crucial too. Dr B has a huge amount of information about various insulins, including regular. His message isn't just VLC. He is dedicated to using his insulin in a very precise way. I think that's great. The tiny amounts of food - not so much so.

 

[tim2000s]

He is dedicated to using his insulin in a very precise way.

It's quite interesting, because as you start to gain an understanding of how a pump can be used, you do something very similar, just using a single type of insulin rather than his wide array of them.

 

[azure]

It's quite interesting, because as you start to gain an understanding of how a pump can be used, you do something very similar, just using a single type of insulin rather than his wide array of them.

Yes - and I think Dr B undervalues pumps a bit. Or rather, doesn't appreciate what they can do for many people. I know he's updated his book, but I still think pumps don't get much attention in it.

 

[Clivethedrive]

While ever virtually all medical research is funded or conducted by pharmaceutical companies, there will never be large scale research into methods that reduce the requirement for medication. Following Dr Bernstein's approach every diabetic would require less insulin, lower sales for pharmaceutical companies, lower profits. Who exactly would fund this research?

Dr Bernstein is an inspirational man and his honesty and integrity shine through. At his age, he cannot still 'need' to be working, purely for financial gain. I listen to his webinars often and he is a genuine, caring and committed individual.

A very low carbohydrate diet can be very enjoyable and satisfying, you just need to work at it.

Even if you do not want to go to the extremes of the tight control that he achieves and the discipline that he encourages, his 'Law of Small Numbers' makes perfect sense, as he puts it, industrial quantities of insulin are impossible to predict and control. My father was diagnosed in the late thirties, I was born in the early 50s and I was definitely brought up in a low carb / controlled carb household, I just didn't recognise it as such at the time. Strict carb restriction was the norm for diabetics before the guidelines changes towards whole grain etc. I remember my father would have none of it when his diabetic clinic told him he should have umpteen servings of carbohydrate a day.

We have a few courageous doctors, willing to challenge the status quo, Bernstein is one of them, along with Noakes, Mulhotra, Unwin and Kendrick. We should not underestimate their endeavours.

So very true @AtkinsMo, succinctly put.

 

[azure]

Nope - just checked my latest version of the Dr B book and pumps aren't done justice, in my opinion.

 

[Diamattic]

Nope - just checked my latest version of the Dr B book and pumps aren't done justice, in my opinion.

At this point i dont think he will personally ever switch to a pump. He has a system that works really well for him - hes locked in. So don't expect to see his opinion on pumps change much since he wont have real first hand experience with them - but that is understandable.

I do however think it is wrong when sometimes on the forum it is said to newbies that the LCHF diet can prevent complications and it gives the wrong impression because no one can predict that as it is not known who will or will not have them whatever they do.

It well correlated though - there have been numerous studies preformed that show the increased risk of complications with fluctuations in blood sugars through spikes and long term highs, LCHF is a documented method of reducing these fluctuations. What you are saying is the same as saying 'Smoking doesn't cause cancer - it just increases risk - who knows if they would have got that cancer anyway so why are we telling people to quit smoking now'

LCHF will certainly prevent complications IF that person doesn't already have them, however even if they do it will certainly reduce their severity, and potentially allow for healing (i don't like using the word reversed because it implies back to normal and we all know when something heals its rarely perfect again), people should be told that they do have options to reduce risk, there are many and they get to decide. LCHF is just a popular one!

 

[tim2000s]

t well correlated though - there have been numerous studies preformed that show the increased risk of complications with fluctuations in blood sugars through spikes and long term highs, LCHF is a documented method of reducing these fluctuations.

The DCCT trials demonstrated that long term higher blood glucose levels drove increased complications. There isn't a huge amount of research that demonstrates that glycemic variability is also a factor, especially in micro-vascular complications. A lot of this is only just coming to light.

 

[Diamattic]

The DCCT trials demonstrated that long term higher blood glucose levels drove increased complications. There isn't a huge amount of research that demonstrates that glycemic variability is also a factor, especially in micro-vascular complications. A lot of this is only just coming to light.

And that is fine, I am not preaching LCHF as the only method, its simple a popular one that can achieve lower stable BS.

BUT when you look at this from a nutritional perspective one will require a well rounded and complete diet and LCHF has been shown to be a safe and balance diet when practiced properly. Simply going low carb without increasing protein and fat consumption is not nearly as healthy, so its not safe to tell people to 'go low carb'

 

[tim2000s]

@Diamattic I wasn't disagreeing with you on the diet side. Simply stating that the evidence base on Glycemic Variability is surprisingly small!

 

[Pinkorchid]

At this point i dont think he will personally ever switch to a pump. He has a system that works really well for him - hes locked in. So don't expect to see his opinion on pumps change much since he wont have real first hand experience with them - but that is understandable.



It well correlated though - there have been numerous studies preformed that show the increased risk of complications with fluctuations in blood sugars through spikes and long term highs, LCHF is a documented method of reducing these fluctuations. What you are saying is the same as saying 'Smoking doesn't cause cancer - it just increases risk - who knows if they would have got that cancer anyway so why are we telling people to quit smoking now'

LCHF will certainly prevent complications IF that person doesn't already have them, however even if they do it will certainly reduce their severity, and potentially allow for healing (i don't like using the word reversed because it implies back to normal and we all know when something heals its rarely perfect again), people should be told that they do have options to reduce risk, there are many and they get to decide. LCHF is just a popular one!

Yes I believe that it may lower the risk of complications but where does it say that it will certainly prevent them. The medical professions do not seem to be saying that. If they thought that LCHF was the answer to not getting complications then that would be a big breakthrough in diabetic treatment and the majority of diabetics world wide would hear about it. At the moment it is only a small minority who do LCHF

 

[AtkinsMo]

Yes, @azure, my father was T1 as was my grandmother, my brother and my niece.

Low carbohydrate diets don't have to be mean and boring and you rapidly adjust, if you want to. Having been low carb in excess of 5 years now, I enjoy a luxurious diet. I may only have one or two cherry tomatoes with my salad, but avocado more than compensates, along with a decadent home made mayonnaise. I recently discovered Tim Noakes 'Real Meal Revolution' book and every recipe I've tried so far has been absolutely delicious, I've even had a go at coconut crepes, I've never been into replacing traditional high carb foods with poor substitutes, but I might just be won over by these recipes. You soon get used to no bread, no potatoes, no rice, no pasta, nothing sweet. You do, honestly! I just love my green veggies with rich and creamy sauces, smaller amounts of better quality protein (LCHF does reduce appetite overall).

A small minority may do LCHF, but I would like to bet they have the very best control (the law of small numbers). The key is to thoroughly enjoy the food you can have, not constantly yearn for the stuff you can't! Whenever I have fabulous smoked salmon and creamy scrambled eggs for breakfast, I think how lucky I am to be eating such delicious food!

 

[Brunneria]

I regularly have an enormous beef tomato with a whole blob of mozzarella, olives, avocado, garlic and chilli olive oil for lunch.
Deliciously LCHF, very filling, satisfying and bursting with flavour.

- and nothing like the image people seem to cultivate of The Bernsteinian regime of suffering, deprivation and excessive control.

30g carbs a day is what you make it. I make it filling, satisfying and decadently indulgent.

 

[AtkinsMo]

Totally agree, 30g of carbs can be a tiny amount of ****, or a totally satisfying amount of real food. I honestly wouldn't swap the food I eat now for the food I used to eat.

 

[azure]

If I was Type 2 I would probably eat less carbs because, I would imagine I'd have a fair level of insulin resistance.

This thread is about Bernstein for Type 1s. I don't doubt your food is delicious - so is mine. Equally importantly my HbA1c is 5.2 (last test) and prior to that was even lower when pregnant (4.7).

Dr B's results are due to his amazing dedication and focus on the micro-management of his diabetes. I salute him for that. However, I don't believe his very low carb diet is necessary for Type 1s. A moderate carb intake with correct use of insulin is more appropriate in my opinion.

If you would like to discuss the benefits of Dr B's method for Type 2 (and I can see there may be a number) then please feel free to,start a Type 2 Bernstein thread

 

[AtkinsMo]

Totally accept you trump my experience, in that I have none!

But if I had t1 (and pray God I never will) I would go down the low carb route - basically, why not?

 

[azure]

Totally accept you trump my experience, in that I have none!

But if I had t1 (and pray God I never will) I would go down the low carb route - basically, why not?

I could ask the same question of moderate carbs Why not?

For me, simply because I'm slim enough already, have excellent insulin sensitivity, am still in my reproductive years (have read research about VLC in pregnancy and was advised by my DSN of the necessity of insulin/carbs in the production of breastmilk) - and because it is not necessary to go that low. Nor is it necessary to stress because your blood sugar is 5.4 not 4.7. Just my opinion But one I've thought about a lot over the years I've had Type 1.