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Permalink Reply by Helen Howes on October 21, 2012 at 6:46am

Be patient with it.. This guy knows whereof he speaks.
The only fault I found with it was the recipes, which don't work here (in the UK), but the rest made sense at a time when I really needed it..

HH

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Permalink Reply by acidrock23 on October 21, 2012 at 6:52am

That's the book. My edition doesn't weight that much but it's pretty *heavy*. I read it again a few years ago. I like the way he attacks the medical profession for not attacking diabetes aggressively enough. I have found it possible to achieve ok BG results while eating maybe 4-5x as many carbs as he recommends so I am not entirely buying his approach on that as being necessary however I will admit that eating less carbs is less work, which can be a good thing!! *runs around house* I can't find my copy to see what the first chapter is (and it may be different, as mine is like 15-20 years old...). I find the book interesting but there's so much about eating ultra-low amounts of carbohydrates that I don't find it entirely credible. Although I think that most food discussions here @ Tu tend to be dominated by the very smart low-carb advocates here. I also "cheat" by exercising pretty aggressively, for which one may need to eat bit more. Compared to a lot of runners, I don't eat a lot.

I'd recommend "Think Like a Pancreas" by Gary Scheiner, "Using Insulin" by John Walsh and/ or "Your Diabetes Science Experiment" by Ginger Vieira as much more readable and realistic guides.

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Permalink Reply by Daisy Mae on October 21, 2012 at 7:10am

dear acidrock23, i cannot fathom eating the way he perscribes. i MUST have my carbs Breakfast, Lunch, and Dinner. its not like i use a lot; my days basal rate is 11 units. after all is said and done and tallied up, at the end of my day i average about 30 units of Novolog per day. i shoot for about 35 grams of carbs per meal and sometimes a snack, desert, or cup of coffee. i have NO problem eating dark chocolate, so i indulge every now and then; i am not someone who needs to watch my weight, so the calorie aspect isnt at issue.

how can anyone adhere to such extremes which Dr. Bernstein proposes. whats the point of life if all we do is control our carbs? isnt it enough that we are D?
this is a real ballancing act.

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Permalink Reply by acidrock23 on October 21, 2012 at 7:21am

There's a whole group here on Tu. They may be sleeping in today or something but I'm sure they'll be along! I read both of Gary Taubes' interesting books on the subject and don't disagree that eating carbs appears to have risks associated with it and the general assertion of "common knowledge" that fat is bad and carbs are good appears to be misplaced. He also suggests that there are benefits to eating less carbs however he doesn't say exactly how many you should eat. One of those books (I think "Why We Get Fat") seemed to put the high end of "low carb" at around 75G of carbs, from studies from some scientist or other, or maybe a couple, which seems much more reasonable than 25/ day that Dr. B recommends (ok, it's 24...to me, 1 carb is relatively inconsequential...).

I agree that the balancing act is the crucial part for us. I suspect that if your ratios are correct, eating big carbs is manageable however the balance part of it is *extremely* precise and, if you are off by just a smidgen in ratios and/ or rates, a bigger meal will make a bigger mess to clean up.

I also think that part of the problem is that many doctors, at leaast the ones I've seen, are averse to discussing food at great lengths. It may be that I don't engage with my doctors that much because I think I know everything and mostly go to get blood tests, rx's refilled and get patted on my head. In most cases though, the initial conversations have been "if you want to talk about food, I'll get you an appointment with the dietitian..." which I've done and, perhaps unsuprisingly, their rx is for more carbs than I need, like 180-270G of carbs/day, which is more than I eat, even on a wild binge day.

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Permalink Reply by Daisy Mae on October 21, 2012 at 8:00am

dear acidrock, i believe i am on the low end of carb consuming. i shoot for about 90 - 100 gms a day. thats close to 3 meals at 30+ grams each. i dont have to worry about my weight. i am a skinny little thing. 108lbs at 5'4".
so i am not witholding carbs for the sake of loosing weight.(Phew; thank god!!)

my numbers this month have been excellent as i made some tweeking changes in my basal to carb ratio and its been working out great. my numbers have come down from 180/200 to 75s and 110s. wow. i am just getting use to it.

as far as the doctors go, my endo has a complete team: nutritionist, pump educator, nurses, and the doctor. he takes his time and is very encouraging, as are the others who are under his employ. and these services are 100% free. i see them every three months (thats what Medicare requires in NY state)

i have been with this paricular doctor since 1991, and have never sought medical attention anywhere else. he's wonderful and i recommend him to every D i know.(they all are very pleased).

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Permalink Reply by BadMoonT2 on October 21, 2012 at 11:30am

Daisy Mae, In another life Dr.B was an engineer, perhaps that explains the technical nature of the book, which can make the eyes glaze over. Perhaps reading in smaller chunks would help.

Lots of folks influenced by Dr. B. eat more than his 30g/day, so I it can be helpful to read the book even if you don't buy in 100%. I'm around 30 to 50. BTW further down the thread you said you are at 90 to 100, that's fairly low in my book. The book can help you understand in more detail how diabetes works. This can help you tighten up your control even if you decide to keep your carbs where they are at.

The main thing I picked up From Dr.B's book was that all carbs are not created equal. As a T2 not on insulin, his advice to eliminate sugars and starches was spot on. Understanding how and why all carbs are not equal helps T1's also.

For T1's, understanding the "Law of Small Numbers" is also a very useful tool.

There are lots of good things left I can eat. So after 3yrs+ I have no trouble sticking with the program. Continued good readings on my meter keep me motivated. Most who have eliminated fast acting carbs acknowledge they are addictive. Having said that, I can understand why some choose to keep eating grain, potatoes etc. They were formerly some of my favorite foods.

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Permalink Reply by Jen on October 21, 2012 at 7:34am

I read the older edition years ago at a time when I was about 23 and just starting to get interested in diabetes and read everything I could get my hands on. I found the book interesting, especially the science behind how insulin secretion and such works since I had no idea about that at the time. I just ignored all the stuff about carbohydrates. At the time I was still on NPH so didn't even have I:C ratios and such yet.

I bought the latest edition a few months ago because I saw it on sale. I haven't read it yet. I know I won't follow the diet, and don't really like some things about Bernstein either, but the book still has interesting information to consider in there. I do tend to like "heavy" books, though; I read more nonfiction than I do fiction (my dad is the same way, so I think it's genetic!).

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Permalink Reply by acidrock23 on October 21, 2012 at 7:40am

LOL @ "I just ignored all the stuff about carbohydrates!". Me too, almost exactly the same! I think I may have been fumblingly carb counting in that for bigger food, I'd take bigger shots but just guessed at it for years! Dr. B lost me w/ the "Swedish crackers" that are his only permitted junk food, even though he helpfully included the contact info for the supplier!

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Permalink Reply by Jen on October 21, 2012 at 7:48am

Funnily, I remember the book most because it was the first time I came across U.S. measurements for blood sugar. Before that I didn't even realize there were different scales. For the longest time I could not figure out what he was talking about when he referred to blood sugars of 80 or 200.

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Permalink Reply by Brian (bsc) on October 21, 2012 at 7:49am

I first read Dr. B's book in 2006. I have since read it many times and purchased a number of copies. The current version was released in 2011. His book is not an entertaining book. It is detailed, often technical and there is a lots of subtle things about what he writes. His book is a reference book. Many of us have the same difficulties reading this book that we do reading the encyclopedia.

And while he recommends a very strict diet (6-12-12), that is only one part of his teachings. Just look at how much he talks about subjects such as gastroparesis. It is important to understand, only a small fraction of those that follow his teachings necessarily strictly follow 6-12-12. But you will find that all of those who claim to follow his principles restrict carbs and understand his "Law of Small Numbers."

In truth, none of us really "MUST" have carbs. We may crave them and go through withdrawal when we stop eating them, but carbs are not essential nutrients. It can be very hard to make the transition from a heavy carb diet to a low carb diet. The Atkins diet has an induction phase to help. Bernstein just expects us as diabetics to have the ultimate motivitation and just do it like we are in the Marine Corps.

I would recommend that you read the up front parts of the book, learn what you can from it and "skim" most of it. Think about what he says. You may disagree or question. Look to what other sources say. Think about it some more and reread sections. Although I am what would be considered a follower of Bernstein, I don't always agree with him. And most of all, I adapt what I learn to my situation, which is after wall what you should do.

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Permalink Reply by Holger Schmeken on October 21, 2012 at 10:56am

I think it is not scientifically sound to claim that carbs are not essential nutrients. I think the whole increase in life expectancy we have seen for the last 300 years can be attributed to the general availability of carbs.

I know multiple people with a very unhealthy lifestyles that got very old. Still they are by no means the role model or inspiration for our way of eating. Dr Bernstein has no Diabetes related complications and that is fine. But his genetic disposition might be more effective against the complications than his lifestyle. What about residual beta cells and their long term benefit for glucose control. What about the protective genetic features of the nervous system to be protected against the harmful effects of elevated glood glucose? What about the other long term diabetics with minor complications that admittedly say the had long periods in their life with little control (they even had no meter then). Is it valid to just reduce the problem to "eleminate the carbs and D Life is good"?

To me someone on the strict Bernstein Diet is also risking something. Other risks and complications than the risks of uncontrolled diabetes but still risks. Potentially the strict Bernstein diet has the same risks than having an A1c of 7.5. Seen from this perspective I would like to make the point here that there are shades in between. An underweight person with a very active lifestyle will need something like 100g of carbs per day to keep its weight. To recommend less carbs just for the sake of picture perfect A1c is unbalanced in my view. Even with an A1c of 5.5 the risk of diabetic complications is not taken away - it is just reduced. So why not having an A1c of 6 with 100g per day and feeling very energetic and well? Why not trying day by day to learn something new about carbs and how to handle them? Why not acquiring an arsenal of experiences with food you can utilize when needed? It is not that people always fail to handle higher loads of carbs with exogenous insulin. Actually they can become very good at carb guessing and dosing.

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Permalink Reply by Brian (bsc) on October 21, 2012 at 1:22pm

Carbohydrates are not "essential." Even the Institute of Medicine which establishes the Dietary Reference Index (DRI) for the USDA recommenations says this. They say "The Recommended Dietary Allowance (RDA) for carbohydrate is set at 130 g/d for adults and children based on the average minimum amount of glucose utilized by the brain. This level of intake, however, is typically exceeded to meet energy needs while consuming acceptable intake levels of fat and protein (see Chapter 11)."

If you eat the recommended levels of fat and protein, you can generate enough blood sugar (through gluconeogenesis) to meet all the needs of the brain. In my view carbohydrates are not an "essential" nutrient, you can be perfectly fine without dietary carbs. As to whether that leaves with a diet that is easy and satisfying, that is another question.

I think there is a valid argument that lowering carbs without clearly understanding how to adjust your insulin can leave you vulnerable to dangerous lows and these are as much of a risk as complications. And while we may always be at some risk of complications no matter what our A1c, the DCCT clearly showed that for A1cs above 6% our risk of complications rise exponentially.

I feel very comformtable with my decision to restrict carbs and work towards tight control.

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