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The doctor and diabetes diet controversy

By Staff | Dec 15, 2010

In the preface to his book, Dr. Bernstein’s Diabetic solution, the author says, “Much of what I cover in this book is in direct opposition to the recommendations of the American Diabetes Association and other national diabetes associations. Why? Because if I had followed those guidelines, they would have killed me long ago. Such conflicts include the low-carbohydrate diet I recommendand my insistence that diabetics are entitled to the same normal blood sugars that non-diabetics enjoy.”

Indeed, their survival depends upon it, according to Bernstein. He then goes on to describe his life with diabetes and what he learned that led him to the conclusions he writes about in his book. This article is a summary of that story.

A 115-pound weakling

Richard Bernstein was diagnosed with type 1, or insulin-dependent, diabetes mellitus in 1946 at the age of twelve. For more than two decades, he dutifully followed doctor’s orders. Those orders included a low-fat, high carbohydrate diet. In spite of the low-fat diet, his blood cholesterol became very high. During his 20s and 30s, a time that should have been the prime of his life, many of his body’s systems began to deteriorate: he had kidney stones, “frozen” shoulders, a progressive deformity of his feet with impaired sensation; he had lost the hair on the lower parts of his legs, a sign that he had developed peripheral vascular disease – a complication that can eventually lead to amputation; he was diagnosed with cardiomyopathy – a common cause of heart failure and death among type 1 diabetics; his vision deteriorated – he suffered night blindness, macular edema (swelling of the central part of the retina), and early cataracts; he developed protein in his urine, a sign of advanced kidney disease – at the time, life expectancy for a type 1 diabetic with protein in the urine was five years. He began working out daily at a local gym, but couldn’t build any muscle. After two years of pumping iron, he remained a 115-pound weakling. Finally, he was subject to bouts of hypoglycemia, which is a state of excessively low blood sugar. They were caused by the unpredictable action of the large doses of insulin he was taking to cover his high carbohydrate diet.

The turning point

In October of 1969, Bernstein stumbled upon an ad for a blood sugar meter that would give a reading in one minute, using a single drop of blood. This was a new device that was not available to patients, but only to doctors and hospitals. His wife was a physician, and so he ordered one in her name. By knowing his blood sugar levels, he could catch and correct hypoglycemic episodes before he became disoriented and irrational, which he often did. What he learned from his frequent testing was that his blood sugars swung from lows of under 40 to highs of over 400 about twice daily. A normal blood sugar level is about 85. In an effort to even out his blood sugar levels, he made some experimental modifications to his diet, cutting down on the carbohydrates to permit him to take less insulin. The very high and low blood sugar levels became less frequent. He had succeeded in preventing the extremes. But his levels were not in the normal range. Three years after he had started measuring his blood sugar, his diabetic complications were getting worse, and he was still a 115 pound weakling.

The breakthrough

In his desperation to prevent or reverse the long-term complications of his disease, he began searching the scientific literature. What he found was that diabetic complications had been repeatedly prevented and even reversed in animals. How? By normalizing blood sugar. This information came as a total surprise. It had never occurred to him that keeping blood sugar levels as close to normal as possible for as much of the time as possible would make a difference because this had never been a goal of diabetes treatment, of his or any one else’s that he knew of. When he told his doctor of his discovery, the reply was, “Animals aren’t humans; it’s impossible to normalize human blood sugars.” This was the medical consensus at the time. Indeed, Bernstein had been subscribing to all the English-language diabetes journals, and none of them had mentioned the need for normalizing blood sugars in humans. In fact, every few months he would read another article saying that blood sugar normalization wasn’t even remotely possible in humans. But that’s what he set out to do. How he did it will be the subject of next week’s column.

Mary Lou Williams, M. Ed., is a writer and lecturer in the field of nutrition. She welcomes inquiries. She can be reached at 267-6480.