Re: The Atkins of diabetes

August 1, 2006

Good article. I concur with its findings except that I'm not sure one

must go quite so low as Dr. Bernstein advocates. And his recipes don't

sound delicious to me! (grin) But I routinely eat less carbs than an

ADA diet would strictly prescribe. Also, I like fruit so eat some -- but

a lot less than dietitians normally advocate. I will say this: if one

doesn't eat fruit, one had better eat plenty of fiber from other

sources.

But I can testify that, for me, at least, it's quite possible to get the

A1C well below 6 without hypoglycemic episodes.

Mike

> The Atkins of diabetes

> Headshot of Lorne stein

>

> LORNE RUBENSTEIN

>

> From Saturday's Globe and Mail

> list of 3 items

> E-mail Lorne stein

> |

> Read Bio

> |

> Latest Columns

> list end

>

> When I was diagnosed with Type 2 diabetes four years ago, I immediately

adopted a new diet, carefully following Canadian Diabetes Association

guidelines.

> But despite sticking to the regimen, my blood sugar was still off the charts.

I feared blindness, a stroke. Or perhaps the loss of a leg.

>

> Then I heard about Bernstein. The endocrinologist is often described

as a " maverick " for his diabetes treatments.

>

> Flying in the face of guidelines set by the American Diabetes Association

(and, by extension, the Canadian Diabetes Association), the 72-year-old

advocates

> a radical decrease in blood-sugar levels through major carb-cutting. So major

in fact, that one could say Dr. Bernstein " out-Atkins " Atkins, recommending

> a sustained ultralow-carb diet, rather than easing diabetics off and back onto

their bread baskets.

>

> Though Dr. Bernstein is a Type 1 diabetic himself, his approach is of

particular interest to Type 2 diabetics. A Type 1 diabetic doesn't produce any

insulin,

> so has to take the hormone, usually by injection. A Type 2 diabetic, on the

other hand, either doesn't produce enough insulin to control blood sugar, or

> doesn't use it efficiently - which means diet is crucial to controlling blood

sugar.

>

> Related to this article

> Endocrinologist Dr. Bernstein poses outside his home in Mamaroneck,

New York.

>

> Endocrinologist Dr. Bernstein poses outside his home in Mamaroneck,

New York. (Brad Barket/Getty Images)

>

> Articles

> Related Articles

> list of 1 items

> Obesity impeding X-rays, MRIs

> list end

> Latest Comments

> Comments

> list of 4 items

> I've volunteered at a diabetes clinic and seen the dramatic success...

> I also am a type 2 diabetic; diagnosed March 2006. I am 4'11...

> As a vegitarian with a long history of diabetics (Type I & II...

> 19 reader comments |

> Join the conversation

> list end

> The Globe and Mail

>

> Type 2 diabetes accounts for 90 per cent of diabetes diagnoses, or about 1.8

million Canadians. That number is expected to rise to 2.7 million by 2010,

> along with costs to the health-care system as diabetics who don't control

their blood sugar are forced to deal with complications.

>

> In both Dr. Bernstein's Diabetes Solution and The Diabetes Diet (which he

recommends for non-diabetics as well), Dr. Bernstein argues that the ADA and CDA

> have set blood-sugar controls too high and their diets allow for too many

carbs.

>

> The critical measure for blood sugar is hemoglobin A1C. The ADA and CDA

encourage A1C levels under 7. Dr. Bernstein believes diabetics should strive for

> A1C levels that match sugar levels of those without the disease - which range

from 4 to 6. " I think diabetics should have the same chance to have normal

> blood sugars as non-diabetics, " he says.

>

> , a family medicine and endocrinology professor at the

University of Western Ontario, was the chair of the group that set the CDA's A1C

guidelines

> in 2003. He agrees that, ideally, a diabetic should strive for an A1C of under

6, and that proper eating is important for blood-sugar control.

>

> But Dr. adds that people develop strong cravings while on diets, and

that it takes incredible willpower to overcome them in the long run. Ultimately,

> he thinks Dr. Bernstein's approach is impractical for most people. He is also

not convinced by Dr. Bernstein's informal proofs (his patients are his study

> group), calling his findings " expert opinion, " rather than " conclusive

evidence. "

>

> Dr. Bernstein's A1C goals certainly seemed unrealistic to me when I was first

diagnosed at the age of 54. Even when I followed CDA eating recommendations

> rigorously, my blood sugar often soared to 12.9, far beyond acceptable levels.

After eating carbs, in particular, my blood sugar seemed to spike.

>

> Still, Dr. Bernstein's experience intrigued me. After all, he had become an

endocrinologist later in life as an answer to his own life-threatening

experience

> with diabetes.

>

> Dr. Bernstein's life expectancy was about 30 years when he was diagnosed with

Type 1 diabetes in 1946 at the age of 12. He carefully followed the ADA's

> diet, but by his late 20s, he had both kidney stones and peripheral nerve

damage in his feet.

>

> He realized then, as he writes in The Diabetes Diet, that " my death would not

have come from diabetes per se. I am pretty certain that I would have died

> of kidney failure, a direct result of the low-fat, high-carbohydrate, ADA diet

I followed for 24 years after my diagnosis. "

>

> Then Dr. Bernstein came across an ad in a scientific journal for a glucometer,

or blood-sugar monitor. It was used in hospital emergency rooms to distinguish

> unconscious drunks from unconscious diabetics. The device cost $650, and only

doctors could purchase one.

>

> Luckily, Dr. Bernstein's wife is a doctor (he was an engineer at the time). He

used her stationery to order a glucometer, and became the first diabetic

> to monitor his own blood sugar. He checked his sugars five to eight times

daily for a year, to gauge the effect of different foods. Carbohydrates raised

> his blood sugars. By restricting them dramatically, he achieved normal

readings.

>

> In 1976, Dr. Bernstein submitted his findings to the Journal of the American

Medical Association and the New England Journal of Medicine. The journals

refused

> to publish his findings. " How many patients would use the electric device for

measurement of glucose, insulin, urine, etc.? " the JAMA editor wrote in a

> letter. " You are a spartan and a paragon, but, I fear, not common clay. "

>

> But Dr. Bernstein persisted. He enrolled in medical school at the age of 45,

specializing in endocrinology, and now treats diabetics from around the world.

>

> I was a quick convert to his approach. After incorporating his suggestions -

eating much more protein and fat (more eggs in a week, for instance, than I'd

> had in the previous six months) - my blood sugars came right down, and my

lipid profile improved.

>

> I was concerned that a diet without fruit, which raised my blood sugar, wasn't

healthy. But my Toronto endocrinologist, Goldenberg, tells me that

> no long-term studies show any problems associated with a diet lacking fruit.

>

> At the same time, I was on, and remain on, medication for diabetes, blood

pressure and cholesterol, but I continue to notice that my blood sugar rises to

> a worrisome level any time I cheat on my diet. Carbs make the difference. Low

carbs. Very low carbs.

>

> But one question remained: An important long-term study showed that

complications are most likely to kick in only when one's A1C is above 7 - so why

go

> lower, why not have that cheesecake or bagel?

>

> And so last month I travelled to Dr. Bernstein's office in Mamaroneck, N.Y.,

where he has been practising for nearly 25 years.

>

> His method is painstaking. His first consultation with a patient takes 13

hours, over a couple of days. He asks every patient to complete a 100-item

questionnaire.

> " Every 'yes' answer leads to a discussion, " he says.

>

> In answer to my question about what can happen without tight control of blood

sugars, Dr. Bernstein was very clear: " Every tissue in the body is being damaged

> by high blood sugars. "

>

> As for his spartan diet, his meal plan allows for only six grams of

carbohydrates at breakfast, 12 at lunch and 12 at dinner. Four years ago, my

nutritional

> counsellor recommended that, at 6 feet, 3 inches and a fit 202 pounds, I eat

at least 200 grams per day. One piece of whole-wheat bread alone includes

> 15 grams of carbohydrates.

>

> Whenever I think of having a sandwich, I recall a demonstration Dr. Bernstein

did last February on a CNBC show about diabetes. In response to Hope Kershaw,

> the author of The Complete Guide to Carb Counting, who was insisting that

whole-grain bread was fine for diabetics, Dr. Bernstein chewed on a slice just

> long enough to mix it with his saliva. He then used a test strip to show that

the carbohydrates in the bread had turned to instant glucose.

>

> " My blood sugar would go sky high if I ate this whole piece of bread, " he

said. Ms. Warshaw responded, " I feel that people need a realistic way of

eating. "

>

> Dr. Goldenberg, my own endocrinologist, agrees. " What raises blood sugar is

carbohydrate, " he says. But he adds, " The problem is that many people won't

> live with the [very low] amount of carbohydrate Bernstein suggests. "

>

> It's true that Dr. Bernstein's patients need to be unusually diligent. But

after following his diet, I can't revert to meals loaded with carbs. Besides,

> his recipes are delicious. I have never felt deprived eating his Caesar salad

with Gruyere croutons (5.7 grams of carbs) or his sweet ricotta torte (4.7

> grams of carbs).

>

> And after spending four hours with Dr. Bernstein, I was even more motivated. I

had been watching my carbohydrate intake before our meeting, but wasn't eating

> strictly according to his approach. My post-meal blood sugars ranged from 5.3

to 10.7. Now, after following the diet strictly for a couple of months, my

> sugars have been in a tight range, from 4.2 to 6.7. I feel great.

>

> " You're not overeating, and you're exercising, and if you're really following

the regimen, you probably have better blood sugars than a non-diabetic your

> age, because they're eating all the sweet stuff that sends them up after every

meal, " Dr. Bernstein told me. " So, in a sense, we can do better than

non-diabetics. "

>

> Lorne stein is The Globe and Mail's golf columnist.

>

August 1, 2006

I have never checked out Dr. Bernstein's recipes, but I have just finished

conducting a one year research study on myself, and I came to definitely one

basic conclusion. I believe without a doubt that this conclusion can also

be considered to be a fact. Regardless of how much insulin one uses the

more carbs one consumes the higher one's A1C level will be. A year ago I

was consuming 50±10 grams of total carbs per day and I had an A1C level of

4.9. After getting this reading I gradually increased my carb consumption

to 60±10 grams of carbs, then to 70±10 grams of carbs and finally to 90±15

grams of total carbs per day. So every three months my A1C levels showed

the following:

A1C 4.9, A1C 5.1, A1c 5.4, and dthis month an A1C of 5.6. I might add

that these are all of the A1C readings for the past year, when I did no

regular exercise. So the readings are based solely on carb consumption and

total insulin used per day. Of course the more carbs one consumes, the more

insulin is required.

I believe a type 1 or a type 2 could dramatically reduce their A1C levels

simply by reducing the amount of Carbs consumed each day. The amazing thing

about this experiment is that it confirmed Dr. Bernstein's findings, and I

also ate well even on the very low carb consumption diet. During the past

year I have never experienced a single day of hunger. I believe in eating

and drinking well, and so I did!

In my opinion carb counting is the best way to go.

Re: The Atkins of diabetes

> Good article. I concur with its findings except that I'm not sure one

> must go quite so low as Dr. Bernstein advocates. And his recipes don't

> sound delicious to me! (grin) But I routinely eat less carbs than an

> ADA diet would strictly prescribe. Also, I like fruit so eat some -- but

> a lot less than dietitians normally advocate. I will say this: if one

> doesn't eat fruit, one had better eat plenty of fiber from other

> sources.

>

> But I can testify that, for me, at least, it's quite possible to get the

> A1C well below 6 without hypoglycemic episodes.

>

> Mike

>

>> The Atkins of diabetes

>> Headshot of Lorne stein

>>

>> LORNE RUBENSTEIN

>>

>> From Saturday's Globe and Mail

>> list of 3 items

>> E-mail Lorne stein

>> |

>> Read Bio

>> |

>> Latest Columns

>> list end

>>

>> When I was diagnosed with Type 2 diabetes four years ago, I immediately

>> adopted a new diet, carefully following Canadian Diabetes Association

>> guidelines.

>> But despite sticking to the regimen, my blood sugar was still off the

>> charts. I feared blindness, a stroke. Or perhaps the loss of a leg.

>>

>> Then I heard about Bernstein. The endocrinologist is often

>> described as a " maverick " for his diabetes treatments.

>>

>> Flying in the face of guidelines set by the American Diabetes Association

>> (and, by extension, the Canadian Diabetes Association), the 72-year-old

>> advocates

>> a radical decrease in blood-sugar levels through major carb-cutting. So

>> major in fact, that one could say Dr. Bernstein " out-Atkins " Atkins,

>> recommending

>> a sustained ultralow-carb diet, rather than easing diabetics off and back

>> onto their bread baskets.

>>

>> Though Dr. Bernstein is a Type 1 diabetic himself, his approach is of

>> particular interest to Type 2 diabetics. A Type 1 diabetic doesn't

>> produce any insulin,

>> so has to take the hormone, usually by injection. A Type 2 diabetic, on

>> the other hand, either doesn't produce enough insulin to control blood

>> sugar, or

>> doesn't use it efficiently - which means diet is crucial to controlling

>> blood sugar.

>>

>> Related to this article

>> Endocrinologist Dr. Bernstein poses outside his home in

>> Mamaroneck, New York.

>>

>> Endocrinologist Dr. Bernstein poses outside his home in

>> Mamaroneck, New York. (Brad Barket/Getty Images)

>>

>> Articles

>> Related Articles

>> list of 1 items

>> Obesity impeding X-rays, MRIs

>> list end

>> Latest Comments

>> Comments

>> list of 4 items

>> I've volunteered at a diabetes clinic and seen the dramatic success...

>> I also am a type 2 diabetic; diagnosed March 2006. I am 4'11...

>> As a vegitarian with a long history of diabetics (Type I & II...

>> 19 reader comments |

>> Join the conversation

>> list end

>> The Globe and Mail

>>

>> Type 2 diabetes accounts for 90 per cent of diabetes diagnoses, or about

>> 1.8 million Canadians. That number is expected to rise to 2.7 million by

>> 2010,

>> along with costs to the health-care system as diabetics who don't control

>> their blood sugar are forced to deal with complications.

>>

>> In both Dr. Bernstein's Diabetes Solution and The Diabetes Diet (which he

>> recommends for non-diabetics as well), Dr. Bernstein argues that the ADA

>> and CDA

>> have set blood-sugar controls too high and their diets allow for too many

>> carbs.

>>

>> The critical measure for blood sugar is hemoglobin A1C. The ADA and CDA

>> encourage A1C levels under 7. Dr. Bernstein believes diabetics should

>> strive for

>> A1C levels that match sugar levels of those without the disease - which

>> range from 4 to 6. " I think diabetics should have the same chance to have

>> normal

>> blood sugars as non-diabetics, " he says.

>>

>> , a family medicine and endocrinology professor at the

>> University of Western Ontario, was the chair of the group that set the

>> CDA's A1C guidelines

>> in 2003. He agrees that, ideally, a diabetic should strive for an A1C of

>> under 6, and that proper eating is important for blood-sugar control.

>>

>> But Dr. adds that people develop strong cravings while on diets,

>> and that it takes incredible willpower to overcome them in the long run.

>> Ultimately,

>> he thinks Dr. Bernstein's approach is impractical for most people. He is

>> also not convinced by Dr. Bernstein's informal proofs (his patients are

>> his study

>> group), calling his findings " expert opinion, " rather than " conclusive

>> evidence. "

>>

>> Dr. Bernstein's A1C goals certainly seemed unrealistic to me when I was

>> first diagnosed at the age of 54. Even when I followed CDA eating

>> recommendations

>> rigorously, my blood sugar often soared to 12.9, far beyond acceptable

>> levels. After eating carbs, in particular, my blood sugar seemed to

>> spike.

>>

>> Still, Dr. Bernstein's experience intrigued me. After all, he had become

>> an endocrinologist later in life as an answer to his own life-threatening

>> experience

>> with diabetes.

>>

>> Dr. Bernstein's life expectancy was about 30 years when he was diagnosed

>> with Type 1 diabetes in 1946 at the age of 12. He carefully followed the

>> ADA's

>> diet, but by his late 20s, he had both kidney stones and peripheral nerve

>> damage in his feet.

>>

>> He realized then, as he writes in The Diabetes Diet, that " my death would

>> not have come from diabetes per se. I am pretty certain that I would have

>> died

>> of kidney failure, a direct result of the low-fat, high-carbohydrate, ADA

>> diet I followed for 24 years after my diagnosis. "

>>

>> Then Dr. Bernstein came across an ad in a scientific journal for a

>> glucometer, or blood-sugar monitor. It was used in hospital emergency

>> rooms to distinguish

>> unconscious drunks from unconscious diabetics. The device cost $650, and

>> only doctors could purchase one.

>>

>> Luckily, Dr. Bernstein's wife is a doctor (he was an engineer at the

>> time). He used her stationery to order a glucometer, and became the first

>> diabetic

>> to monitor his own blood sugar. He checked his sugars five to eight times

>> daily for a year, to gauge the effect of different foods. Carbohydrates

>> raised

>> his blood sugars. By restricting them dramatically, he achieved normal

>> readings.

>>

>> In 1976, Dr. Bernstein submitted his findings to the Journal of the

>> American Medical Association and the New England Journal of Medicine. The

>> journals refused

>> to publish his findings. " How many patients would use the electric device

>> for measurement of glucose, insulin, urine, etc.? " the JAMA editor wrote

>> in a

>> letter. " You are a spartan and a paragon, but, I fear, not common clay. "

>>

>> But Dr. Bernstein persisted. He enrolled in medical school at the age of

>> 45, specializing in endocrinology, and now treats diabetics from around

>> the world.

>>

>> I was a quick convert to his approach. After incorporating his

>> suggestions - eating much more protein and fat (more eggs in a week, for

>> instance, than I'd

>> had in the previous six months) - my blood sugars came right down, and my

>> lipid profile improved.

>>

>> I was concerned that a diet without fruit, which raised my blood sugar,

>> wasn't healthy. But my Toronto endocrinologist, Goldenberg, tells

>> me that

>> no long-term studies show any problems associated with a diet lacking

>> fruit.

>>

>> At the same time, I was on, and remain on, medication for diabetes, blood

>> pressure and cholesterol, but I continue to notice that my blood sugar

>> rises to

>> a worrisome level any time I cheat on my diet. Carbs make the difference.

>> Low carbs. Very low carbs.

>>

>> But one question remained: An important long-term study showed that

>> complications are most likely to kick in only when one's A1C is above 7 -

>> so why go

>> lower, why not have that cheesecake or bagel?

>>

>> And so last month I travelled to Dr. Bernstein's office in Mamaroneck,

>> N.Y., where he has been practising for nearly 25 years.

>>

>> His method is painstaking. His first consultation with a patient takes 13

>> hours, over a couple of days. He asks every patient to complete a

>> 100-item questionnaire.

>> " Every 'yes' answer leads to a discussion, " he says.

>>

>> In answer to my question about what can happen without tight control of

>> blood sugars, Dr. Bernstein was very clear: " Every tissue in the body is

>> being damaged

>> by high blood sugars. "

>>

>> As for his spartan diet, his meal plan allows for only six grams of

>> carbohydrates at breakfast, 12 at lunch and 12 at dinner. Four years ago,

>> my nutritional

>> counsellor recommended that, at 6 feet, 3 inches and a fit 202 pounds, I

>> eat at least 200 grams per day. One piece of whole-wheat bread alone

>> includes

>> 15 grams of carbohydrates.

>>

>> Whenever I think of having a sandwich, I recall a demonstration Dr.

>> Bernstein did last February on a CNBC show about diabetes. In response to

>> Hope Kershaw,

>> the author of The Complete Guide to Carb Counting, who was insisting that

>> whole-grain bread was fine for diabetics, Dr. Bernstein chewed on a slice

>> just

>> long enough to mix it with his saliva. He then used a test strip to show

>> that the carbohydrates in the bread had turned to instant glucose.

>>

>> " My blood sugar would go sky high if I ate this whole piece of bread, " he

>> said. Ms. Warshaw responded, " I feel that people need a realistic way of

>> eating. "

>>

>> Dr. Goldenberg, my own endocrinologist, agrees. " What raises blood sugar

>> is carbohydrate, " he says. But he adds, " The problem is that many people

>> won't

>> live with the [very low] amount of carbohydrate Bernstein suggests. "

>>

>> It's true that Dr. Bernstein's patients need to be unusually diligent.

>> But after following his diet, I can't revert to meals loaded with carbs.

>> Besides,

>> his recipes are delicious. I have never felt deprived eating his Caesar

>> salad with Gruyere croutons (5.7 grams of carbs) or his sweet ricotta

>> torte (4.7

>> grams of carbs).

>>

>> And after spending four hours with Dr. Bernstein, I was even more

>> motivated. I had been watching my carbohydrate intake before our meeting,

>> but wasn't eating

>> strictly according to his approach. My post-meal blood sugars ranged from

>> 5.3 to 10.7. Now, after following the diet strictly for a couple of

>> months, my

>> sugars have been in a tight range, from 4.2 to 6.7. I feel great.

>>

>> " You're not overeating, and you're exercising, and if you're really

>> following the regimen, you probably have better blood sugars than a

>> non-diabetic your

>> age, because they're eating all the sweet stuff that sends them up after

>> every meal, " Dr. Bernstein told me. " So, in a sense, we can do better

>> than non-diabetics. "

>>

>> Lorne stein is The Globe and Mail's golf columnist.

>>

August 1, 2006

One thing I wonder about the really low carb diets is how do you accomodate

exercise? I almost always use a combination of reduced insulin and a snack of 10

or so carbs for every hour of exercise I'll be doing. If I just reduce insulin I

almost always go high afterwards, and if I just eat a snack without reducing it

then I go low afterwards.

Does the carbs eaten for exercise just not count towards the total?

I do not eat low carb. In fact I eat a bad diet as far as carbs are concerned.

And my blood sugars have been insane this past week, I'm hoping just from

stress.

Jen

Re: The Atkins of diabetes

>

> > Good article. I concur with its findings except that I'm not

> sure one

> > must go quite so low as Dr. Bernstein advocates. And his recipes

> don't> sound delicious to me! (grin) But I routinely eat less

> carbs than an

> > ADA diet would strictly prescribe. Also, I like fruit so eat

> some -- but

> > a lot less than dietitians normally advocate. I will say this:

> if one

> > doesn't eat fruit, one had better eat plenty of fiber from other

> > sources.

> >

> > But I can testify that, for me, at least, it's quite possible to

> get the

> > A1C well below 6 without hypoglycemic episodes.

> >

> > Mike

> >

> >> The Atkins of diabetes

> >> Headshot of Lorne stein

> >>

> >> LORNE RUBENSTEIN

> >>

> >> From Saturday's Globe and Mail

> >> list of 3 items

> >> E-mail Lorne stein

> >> |

> >> Read Bio

> >> |

> >> Latest Columns

> >> list end

> >>

> >> When I was diagnosed with Type 2 diabetes four years ago, I

> immediately

> >> adopted a new diet, carefully following Canadian Diabetes

> Association

> >> guidelines.

> >> But despite sticking to the regimen, my blood sugar was still

> off the

> >> charts. I feared blindness, a stroke. Or perhaps the loss of a leg.

> >>

> >> Then I heard about Bernstein. The endocrinologist is

> often

> >> described as a " maverick " for his diabetes treatments.

> >>

> >> Flying in the face of guidelines set by the American Diabetes

> Association

> >> (and, by extension, the Canadian Diabetes Association), the 72-

> year-old

> >> advocates

> >> a radical decrease in blood-sugar levels through major carb-

> cutting. So

> >> major in fact, that one could say Dr. Bernstein " out-Atkins "

> Atkins,

> >> recommending

> >> a sustained ultralow-carb diet, rather than easing diabetics

> off and back

> >> onto their bread baskets.

> >>

> >> Though Dr. Bernstein is a Type 1 diabetic himself, his approach

> is of

> >> particular interest to Type 2 diabetics. A Type 1 diabetic

> doesn't

> >> produce any insulin,

> >> so has to take the hormone, usually by injection. A Type 2

> diabetic, on

> >> the other hand, either doesn't produce enough insulin to

> control blood

> >> sugar, or

> >> doesn't use it efficiently - which means diet is crucial to

> controlling

> >> blood sugar.

> >>

> >> Related to this article

> >> Endocrinologist Dr. Bernstein poses outside his home in

> >> Mamaroneck, New York.

> >>

> >> Endocrinologist Dr. Bernstein poses outside his home in

> >> Mamaroneck, New York. (Brad Barket/Getty Images)

> >>

> >> Articles

> >> Related Articles

> >> list of 1 items

> >> Obesity impeding X-rays, MRIs

> >> list end

> >> Latest Comments

> >> Comments

> >> list of 4 items

> >> I've volunteered at a diabetes clinic and seen the dramatic

> success...>> I also am a type 2 diabetic; diagnosed March 2006. I

> am 4'11...

> >> As a vegitarian with a long history of diabetics (Type I & II...

> >> 19 reader comments |

> >> Join the conversation

> >> list end

> >> The Globe and Mail

> >>

> >> Type 2 diabetes accounts for 90 per cent of diabetes diagnoses,

> or about

> >> 1.8 million Canadians. That number is expected to rise to 2.7

> million by

> >> 2010,

> >> along with costs to the health-care system as diabetics who

> don't control

> >> their blood sugar are forced to deal with complications.

> >>

> >> In both Dr. Bernstein's Diabetes Solution and The Diabetes Diet

> (which he

> >> recommends for non-diabetics as well), Dr. Bernstein argues

> that the ADA

> >> and CDA

> >> have set blood-sugar controls too high and their diets allow

> for too many

> >> carbs.

> >>

> >> The critical measure for blood sugar is hemoglobin A1C. The ADA

> and CDA

> >> encourage A1C levels under 7. Dr. Bernstein believes diabetics

> should

> >> strive for

> >> A1C levels that match sugar levels of those without the disease

> - which

> >> range from 4 to 6. " I think diabetics should have the same

> chance to have

> >> normal

> >> blood sugars as non-diabetics, " he says.

> >>

> >> , a family medicine and endocrinology professor

> at the

> >> University of Western Ontario, was the chair of the group that

> set the

> >> CDA's A1C guidelines

> >> in 2003. He agrees that, ideally, a diabetic should strive for

> an A1C of

> >> under 6, and that proper eating is important for blood-sugar

> control.>>

> >> But Dr. adds that people develop strong cravings while

> on diets,

> >> and that it takes incredible willpower to overcome them in the

> long run.

> >> Ultimately,

> >> he thinks Dr. Bernstein's approach is impractical for most

> people. He is

> >> also not convinced by Dr. Bernstein's informal proofs (his

> patients are

> >> his study

> >> group), calling his findings " expert opinion, " rather than

> " conclusive

> >> evidence. "

> >>

> >> Dr. Bernstein's A1C goals certainly seemed unrealistic to me

> when I was

> >> first diagnosed at the age of 54. Even when I followed CDA

> eating

> >> recommendations

> >> rigorously, my blood sugar often soared to 12.9, far beyond

> acceptable

> >> levels. After eating carbs, in particular, my blood sugar

> seemed to

> >> spike.

> >>

> >> Still, Dr. Bernstein's experience intrigued me. After all, he

> had become

> >> an endocrinologist later in life as an answer to his own life-

> threatening

> >> experience

> >> with diabetes.

> >>

> >> Dr. Bernstein's life expectancy was about 30 years when he was

> diagnosed

> >> with Type 1 diabetes in 1946 at the age of 12. He carefully

> followed the

> >> ADA's

> >> diet, but by his late 20s, he had both kidney stones and

> peripheral nerve

> >> damage in his feet.

> >>

> >> He realized then, as he writes in The Diabetes Diet, that " my

> death would

> >> not have come from diabetes per se. I am pretty certain that I

> would have

> >> died

> >> of kidney failure, a direct result of the low-fat, high-

> carbohydrate, ADA

> >> diet I followed for 24 years after my diagnosis. "

> >>

> >> Then Dr. Bernstein came across an ad in a scientific journal

> for a

> >> glucometer, or blood-sugar monitor. It was used in hospital

> emergency

> >> rooms to distinguish

> >> unconscious drunks from unconscious diabetics. The device cost

> $650, and

> >> only doctors could purchase one.

> >>

> >> Luckily, Dr. Bernstein's wife is a doctor (he was an engineer

> at the

> >> time). He used her stationery to order a glucometer, and became

> the first

> >> diabetic

> >> to monitor his own blood sugar. He checked his sugars five to

> eight times

> >> daily for a year, to gauge the effect of different foods.

> Carbohydrates

> >> raised

> >> his blood sugars. By restricting them dramatically, he achieved

> normal

> >> readings.

> >>

> >> In 1976, Dr. Bernstein submitted his findings to the Journal of

> the

> >> American Medical Association and the New England Journal of

> Medicine. The

> >> journals refused

> >> to publish his findings. " How many patients would use the

> electric device

> >> for measurement of glucose, insulin, urine, etc.? " the JAMA

> editor wrote

> >> in a

> >> letter. " You are a spartan and a paragon, but, I fear, not

> common clay. "

> >>

> >> But Dr. Bernstein persisted. He enrolled in medical school at

> the age of

> >> 45, specializing in endocrinology, and now treats diabetics

> from around

> >> the world.

> >>

> >> I was a quick convert to his approach. After incorporating his

> >> suggestions - eating much more protein and fat (more eggs in a

> week, for

> >> instance, than I'd

> >> had in the previous six months) - my blood sugars came right

> down, and my

> >> lipid profile improved.

> >>

> >> I was concerned that a diet without fruit, which raised my

> blood sugar,

> >> wasn't healthy. But my Toronto endocrinologist,

> Goldenberg, tells

> >> me that

> >> no long-term studies show any problems associated with a diet

> lacking

> >> fruit.

> >>

> >> At the same time, I was on, and remain on, medication for

> diabetes, blood

> >> pressure and cholesterol, but I continue to notice that my

> blood sugar

> >> rises to

> >> a worrisome level any time I cheat on my diet. Carbs make the

> difference.

> >> Low carbs. Very low carbs.

> >>

> >> But one question remained: An important long-term study showed

> that

> >> complications are most likely to kick in only when one's A1C is

> above 7 -

> >> so why go

> >> lower, why not have that cheesecake or bagel?

> >>

> >> And so last month I travelled to Dr. Bernstein's office in

> Mamaroneck,

> >> N.Y., where he has been practising for nearly 25 years.

> >>

> >> His method is painstaking. His first consultation with a

> patient takes 13

> >> hours, over a couple of days. He asks every patient to complete

> a

> >> 100-item questionnaire.

> >> " Every 'yes' answer leads to a discussion, " he says.

> >>

> >> In answer to my question about what can happen without tight

> control of

> >> blood sugars, Dr. Bernstein was very clear: " Every tissue in

> the body is

> >> being damaged

> >> by high blood sugars. "

> >>

> >> As for his spartan diet, his meal plan allows for only six

> grams of

> >> carbohydrates at breakfast, 12 at lunch and 12 at dinner. Four

> years ago,

> >> my nutritional

> >> counsellor recommended that, at 6 feet, 3 inches and a fit 202

> pounds, I

> >> eat at least 200 grams per day. One piece of whole-wheat bread

> alone

> >> includes

> >> 15 grams of carbohydrates.

> >>

> >> Whenever I think of having a sandwich, I recall a demonstration

> Dr.

> >> Bernstein did last February on a CNBC show about diabetes. In

> response to

> >> Hope Kershaw,

> >> the author of The Complete Guide to Carb Counting, who was

> insisting that

> >> whole-grain bread was fine for diabetics, Dr. Bernstein chewed

> on a slice

> >> just

> >> long enough to mix it with his saliva. He then used a test

> strip to show

> >> that the carbohydrates in the bread had turned to instant glucose.

> >>

> >> " My blood sugar would go sky high if I ate this whole piece of

> bread, " he

> >> said. Ms. Warshaw responded, " I feel that people need a

> realistic way of

> >> eating. "

> >>

> >> Dr. Goldenberg, my own endocrinologist, agrees. " What raises

> blood sugar

> >> is carbohydrate, " he says. But he adds, " The problem is that

> many people

> >> won't

> >> live with the [very low] amount of carbohydrate Bernstein

> suggests. " >>

> >> It's true that Dr. Bernstein's patients need to be unusually

> diligent.

> >> But after following his diet, I can't revert to meals loaded

> with carbs.

> >> Besides,

> >> his recipes are delicious. I have never felt deprived eating

> his Caesar

> >> salad with Gruyere croutons (5.7 grams of carbs) or his sweet

> ricotta

> >> torte (4.7

> >> grams of carbs).

> >>

> >> And after spending four hours with Dr. Bernstein, I was even

> more

> >> motivated. I had been watching my carbohydrate intake before

> our meeting,

> >> but wasn't eating

> >> strictly according to his approach. My post-meal blood sugars

> ranged from

> >> 5.3 to 10.7. Now, after following the diet strictly for a

> couple of

> >> months, my

> >> sugars have been in a tight range, from 4.2 to 6.7. I feel great.

> >>

> >> " You're not overeating, and you're exercising, and if you're

> really

> >> following the regimen, you probably have better blood sugars

> than a

> >> non-diabetic your

> >> age, because they're eating all the sweet stuff that sends them

> up after

> >> every meal, " Dr. Bernstein told me. " So, in a sense, we can do

> better

> >> than non-diabetics. "

> >>

> >> Lorne stein is The Globe and Mail's golf columnist.

> >>

August 1, 2006

Harry,

Sorry but, what is 50?10? The symbol between the 50 and the 10 is

unintelligible to my JAWS.

Let me see, who was it who said " large doses, large mistakes, little doses,

little mistakes " ?

My, but this philosophy of lowering carb consumption sure sounds familiar.

Wonder where I have heard this before? (LOL)

I do concur with your theory though. The more carbs you ingest the more you

have to fiddle with something in order to reduce the sugar level and somehow

I do think that lots of sugar, although neutralized, will still make its

mark somewhere.

Cy, the Ancient Okie...