Diabetes Solution is not a "diet book" in the sense of weight loss program. It's a diet as a "habitual food and drink of a person," in which a person with diabetes can control diabetes and prevent complications through proper eating. Few people without diabetes will be interested in this review. On Amazon.com's rating system, I give this book five stars ("I love it").
♦ ♦ ♦
Dr. Bernstein gives away thousands of dollars worth of medical advice in this masterpiece, Diabetes Solution. It's a summation of medical career and a gift to the diabetes community.blue heron health news reviews
The book starts off with some incredible testimonials: reversal or diabetic nerve damage, eye damage, and erectile dysfunction. They're a bit off-putting to a skeptic like me, like an infomercial. Dr. Bernstein is either lying about these or he's not; I believe him. His strongest testimonial is his own. He's been a type 1 diabetic most of his life, having acquired the disease at a time when most type 1's never saw 55 candles on a birthday cake. He's in his mid-70s now and still working vigorously.
I only found one obvious error and it's a misprint. He writes that 95% of people born today in the U.S. will eventually develop diabetes. The U.S. Centers for Disease Control, on the other hand, predicts that one in three born in 2000 will be diagnosed.
Dr. Bernstein delivers lots of facts that I can neither confirm nor refute. He's a full-time diabetologist; I am not.
The central problem in type 1 diabetes is that, due to a lack of insulin, carbohydrates lead to spikes (elevations) in blood sugar. The sugar elevations themselves are toxic. The usual insulin injections are not good imitators of healthy pancreatic gland. So Dr. Bernstein is an advocate or low-carb eating (about 30 g daily compared to the usual American 250-300 g). He says the available insulin CAN handle the glucose produced by a high-protein meal.the diabetes solution reviews
Dr. B reminds us that insulin is the main fat-building hormone, which is one reason diabetics gain weight when they start insulin, and why type 2 diabetics with insulin resistance (and high blood insulin levels) are overweight and have trouble losing weight. You can resist blood sugar lowering action yet no resistance to fat-building action. Insulin also stimulates hunger, so insulin-resistant diabetics are often hungry.ngoa buyers club review
"Carbohydrate counting" is a popular method for determining a dose of injected insulin. Dr. B says the gram counts on most foods are rough estimate-far too rough. He minimizes the error by minimizing the input (ingested carbs). From his days as an engineer, he notes "small inputs, small mistakes."
Dr. Bites cites problems with the absorption of injected insulin. Absorption is variable: the larger the dose, the greater the variability. So do not let a lot of carbs that require a large insulin dose. For adult type 1 diabetics, his recommended rapid-acting insulin doses are usually three to five units. If larger than seven units is needed, split it into different sites.
He recommends diabetics for normal glucoses (90 mg / dl or less) almost all the time, and hemoglobin A1c or 5% or less. This is extremely tight control, tighter than any expert panel recommends. This is the best way to avoid the serious complications of diabetes.
Here's a smattering or "facts" in the book that had an impact on me, a physician practicing internal medicine for over two decades. I want to remember them, incorporate into my practice, or research further to confirm:
Hemoglobin A1c or 5% equals an average blood sugar or 100 mg / dl (5.56 mmol / l). For each one% higher, average glucose is 40 mg / dl (2.22 mmol / l) higher.
The remaining pancreatic function in type 2 diabetics: sulphonylureas, meglitinides, "phenylalanine derivatives". Pancreatic provoking agents cause hypoglycemia and destroy beta cell function.
The insulin sensitizers are metformin and thiazolidinediones. He likes these.
Blood sugar normalization in type 2 diabetes and early-stage type 1 can help restore beta cell function.
He speaks or preserves beta cell function.
He believes in "insulin-mimetic agents" like alpha lipoic acid (especially R-ALA, and take biotin with form) and evening primrose oil. These are no substitute for insulin injections but allow for lower insulin doses. ALA and evening primrose do not promote fat storage like insulin does.
He says many cardiologists take ALA for its antioxidant properties [news to me]
He says rosiglitazone works within two hours [news to me] but later admits it may take 12 weeks to see maximal benefit
One of his goals is to preserve beta cell function if at all possible
He prefers rosiglitazone about pioglitazone due to less drug interactions
"Americans are fat because of sugar, starches, and other high-carbohydrate foods."
He's convinced that people who have carbohydrates have inherited the problem, which also predisposes to insulin resistance and type 2 diabetes. Low-carb the decrease the cravings for many, in his experience.
In small amounts, alcohol is relatively harmless: dry wine, beer, spirits. Very few doctors have the courage to say this.
If you're in a restaurant, you can use urine sugar test strips and saliva to test for the presence of sugar or flour in food
A rule of thumb: one gram of carbohydrate will raise blood sugar about 5 mg / dl (0.28 mmol / l) or less for most diabetic adults weighing 140 lb (64 kg) and about 2.5 mg / dl (0.139 mmol / l) in a 280-pounder (127 kg). This must refer to type 1 diabetics or type 2 with little residual pancreatic beta cell function; variable degrees of insulin resistance and beta cell reserve in many type 2s would make this formula unreliable.
Be wary or maltodextrin in Splenda: it does raise blood sugar.
Much new to me in his section on artificial sweeteners. Be wary of them.
He avoids all grains, breads, crackers, barley, oats, rice, and pasta.
Most diet sodas are OK.
Coffees with 1-2 tsp milk is OK. Cream is OK.
He eats NO fruit and recommends against it.
He avoids bite, corn, potatoes, and beans. A slice or tomato in one cup or salad is OK. A small amount of onion is OK.
String beans and snow peas are OK.
Cooked vegetables tend to raise blood sugar more rapidly than raw.
Use "Equal" aspartame tabs as a sweetener. Do not use "powdered" Splenda.
Avoid nuts: too easy to overeat.
For desert: sugar-free Jell-O Brand Gelatin.
Yogurt? Plain, whole milk, unsweetened. Flavor with cinnamon, Da Vinci syrups, baking flavor extracts, stevia or Equal.
Avoid balsamic vinegar.
Need fiber? Bran crackers or soybean products.
"Ideally, your blood sugar should be the same after eating as it was before." 85 mg / dl (4.72 mmol / l) is his usual goal. If blood sugar rises by more than 10 mg / dl (0.56 mmol / l) after a meal, or the meal has changed.
Protein is a source of glucose: keep protein levels at meals constant from day to day, especially if taking glucose-lowering drugs.
The lowest-carb meal of the day should be break-down. Why? Dawn phenomenon.
He promotes strenuous, prolonged exercise, especially weight training (extensive discussion and instruction in book).
Many diabetics on insulin need dose adjustments in 1/2 and 1/4 unit increments [news to me: if I ordered 4 and 1/4 units of the hospital, the nurses would laugh].
Typical rapid-acting insulin doses for his adult type 1 patients are 3-5 units. The "industrial doses" of insulin seen or recommended by many physicians do not reflect too high in carbohydrate.
He says Lantus only acts for nine hours (nighttime injection) or 18 hours (AM injection).
He does not like mixed insulins (e.g., 70/30).
Humalog and Novolog are more potent than regular insulin, so the dose is about 2/3 of the regular insulin dose
"Only a few of the 20 available [home glucose monitoring] machines are suitably accurate for our purposes." "None are suitably accurate or precise above 200 mg / dl [11.11 mmol / l]."
Vitamin C in doses over 250 mg interferes with fingertip glucose monitors. Later he says doses about 500 mg of cause falsely low readings.
He prefers regular insulin (45 minutes before meal) about Novolog and Humalog, because of its five-hour duration of action.
Insulin users need to check glucose levels hourly while driving.
His personal basal insulin is 3 units Lantus twice daily.
He urges use of glucose (e.g., Dextrotabs) to correct hypoglycemia.
He says hypoglycemia is weird on his regimen.
He has an entire chapter on gastroparesis.
His recommended eating program in a nutshell:
Some similarities to the Atkins diet, which he never mentions.
No simple sugars or "fast-acting" carbs like bread and potatoes, because even type 2s have impaired or nonexistent phase 1 insulin response.
Limit carbs to an amount that will work with your injected insulin or your remaining phase 2 insulin response, if any.
"Stop eating when you no longer feel hungry, not when you're stuffed."
Follow a predetermined meal plan (each meal: same grams of carb and ounces of protein)
Six g (or less) or carbs at breakfast, 12 g (or less) at lunch and evening meal. So his patients count carb grams and protein ounces.
Supplements are not required IF glucoses are controlled and used in a variety of veggies. Otherwise you may need B-complex or multivitamin / multimineral supplement.
Recipes are provided.
His has four basic drug treatment plans, tailored to the individual. They are outlined in the book. Dr. B provides detailed notes on what he does with his personal patients.
Overall impressions:
Too complicated for most, and they will not give up higher carb consumption. It requires a high degree of commitment and discipline. In fact, I've never had a patient tell me they were on the Bernstein program.
If I had type 1 diabetes, I might well follow his plan or the Diabetic Mediterranean Diet, NOT the high-carb diet recommended by the ADA and many dietitians.
And if I had type 2 diabetes? Diabetic Mediterranean Diet first, Diabetes Solution as second choice.
If one can get his hemoglobins A1c down to 5% with other methods, would that be just as good? Dr. B would argue that all other methods have blood sugar swings that are too wide.
Many new ideas and techniques here, at least to me.
He is pretty much reveals his entire program here, which is priceless.
I'm not sure this plan will work unless the patient's treating physician is on-board.
His personal testimony and breadth of knowledge are very persuasive.
♦ ♦ ♦
Dr. Bernstein gives away thousands of dollars worth of medical advice in this masterpiece, Diabetes Solution. It's a summation of medical career and a gift to the diabetes community.blue heron health news reviews
The book starts off with some incredible testimonials: reversal or diabetic nerve damage, eye damage, and erectile dysfunction. They're a bit off-putting to a skeptic like me, like an infomercial. Dr. Bernstein is either lying about these or he's not; I believe him. His strongest testimonial is his own. He's been a type 1 diabetic most of his life, having acquired the disease at a time when most type 1's never saw 55 candles on a birthday cake. He's in his mid-70s now and still working vigorously.
I only found one obvious error and it's a misprint. He writes that 95% of people born today in the U.S. will eventually develop diabetes. The U.S. Centers for Disease Control, on the other hand, predicts that one in three born in 2000 will be diagnosed.
Dr. Bernstein delivers lots of facts that I can neither confirm nor refute. He's a full-time diabetologist; I am not.
The central problem in type 1 diabetes is that, due to a lack of insulin, carbohydrates lead to spikes (elevations) in blood sugar. The sugar elevations themselves are toxic. The usual insulin injections are not good imitators of healthy pancreatic gland. So Dr. Bernstein is an advocate or low-carb eating (about 30 g daily compared to the usual American 250-300 g). He says the available insulin CAN handle the glucose produced by a high-protein meal.the diabetes solution reviews
Dr. B reminds us that insulin is the main fat-building hormone, which is one reason diabetics gain weight when they start insulin, and why type 2 diabetics with insulin resistance (and high blood insulin levels) are overweight and have trouble losing weight. You can resist blood sugar lowering action yet no resistance to fat-building action. Insulin also stimulates hunger, so insulin-resistant diabetics are often hungry.ngoa buyers club review
"Carbohydrate counting" is a popular method for determining a dose of injected insulin. Dr. B says the gram counts on most foods are rough estimate-far too rough. He minimizes the error by minimizing the input (ingested carbs). From his days as an engineer, he notes "small inputs, small mistakes."
Dr. Bites cites problems with the absorption of injected insulin. Absorption is variable: the larger the dose, the greater the variability. So do not let a lot of carbs that require a large insulin dose. For adult type 1 diabetics, his recommended rapid-acting insulin doses are usually three to five units. If larger than seven units is needed, split it into different sites.
He recommends diabetics for normal glucoses (90 mg / dl or less) almost all the time, and hemoglobin A1c or 5% or less. This is extremely tight control, tighter than any expert panel recommends. This is the best way to avoid the serious complications of diabetes.
Here's a smattering or "facts" in the book that had an impact on me, a physician practicing internal medicine for over two decades. I want to remember them, incorporate into my practice, or research further to confirm:
Hemoglobin A1c or 5% equals an average blood sugar or 100 mg / dl (5.56 mmol / l). For each one% higher, average glucose is 40 mg / dl (2.22 mmol / l) higher.
The remaining pancreatic function in type 2 diabetics: sulphonylureas, meglitinides, "phenylalanine derivatives". Pancreatic provoking agents cause hypoglycemia and destroy beta cell function.
The insulin sensitizers are metformin and thiazolidinediones. He likes these.
Blood sugar normalization in type 2 diabetes and early-stage type 1 can help restore beta cell function.
He speaks or preserves beta cell function.
He believes in "insulin-mimetic agents" like alpha lipoic acid (especially R-ALA, and take biotin with form) and evening primrose oil. These are no substitute for insulin injections but allow for lower insulin doses. ALA and evening primrose do not promote fat storage like insulin does.
He says many cardiologists take ALA for its antioxidant properties [news to me]
He says rosiglitazone works within two hours [news to me] but later admits it may take 12 weeks to see maximal benefit
One of his goals is to preserve beta cell function if at all possible
He prefers rosiglitazone about pioglitazone due to less drug interactions
"Americans are fat because of sugar, starches, and other high-carbohydrate foods."
He's convinced that people who have carbohydrates have inherited the problem, which also predisposes to insulin resistance and type 2 diabetes. Low-carb the decrease the cravings for many, in his experience.
In small amounts, alcohol is relatively harmless: dry wine, beer, spirits. Very few doctors have the courage to say this.
If you're in a restaurant, you can use urine sugar test strips and saliva to test for the presence of sugar or flour in food
A rule of thumb: one gram of carbohydrate will raise blood sugar about 5 mg / dl (0.28 mmol / l) or less for most diabetic adults weighing 140 lb (64 kg) and about 2.5 mg / dl (0.139 mmol / l) in a 280-pounder (127 kg). This must refer to type 1 diabetics or type 2 with little residual pancreatic beta cell function; variable degrees of insulin resistance and beta cell reserve in many type 2s would make this formula unreliable.
Be wary or maltodextrin in Splenda: it does raise blood sugar.
Much new to me in his section on artificial sweeteners. Be wary of them.
He avoids all grains, breads, crackers, barley, oats, rice, and pasta.
Most diet sodas are OK.
Coffees with 1-2 tsp milk is OK. Cream is OK.
He eats NO fruit and recommends against it.
He avoids bite, corn, potatoes, and beans. A slice or tomato in one cup or salad is OK. A small amount of onion is OK.
String beans and snow peas are OK.
Cooked vegetables tend to raise blood sugar more rapidly than raw.
Use "Equal" aspartame tabs as a sweetener. Do not use "powdered" Splenda.
Avoid nuts: too easy to overeat.
For desert: sugar-free Jell-O Brand Gelatin.
Yogurt? Plain, whole milk, unsweetened. Flavor with cinnamon, Da Vinci syrups, baking flavor extracts, stevia or Equal.
Avoid balsamic vinegar.
Need fiber? Bran crackers or soybean products.
"Ideally, your blood sugar should be the same after eating as it was before." 85 mg / dl (4.72 mmol / l) is his usual goal. If blood sugar rises by more than 10 mg / dl (0.56 mmol / l) after a meal, or the meal has changed.
Protein is a source of glucose: keep protein levels at meals constant from day to day, especially if taking glucose-lowering drugs.
The lowest-carb meal of the day should be break-down. Why? Dawn phenomenon.
He promotes strenuous, prolonged exercise, especially weight training (extensive discussion and instruction in book).
Many diabetics on insulin need dose adjustments in 1/2 and 1/4 unit increments [news to me: if I ordered 4 and 1/4 units of the hospital, the nurses would laugh].
Typical rapid-acting insulin doses for his adult type 1 patients are 3-5 units. The "industrial doses" of insulin seen or recommended by many physicians do not reflect too high in carbohydrate.
He says Lantus only acts for nine hours (nighttime injection) or 18 hours (AM injection).
He does not like mixed insulins (e.g., 70/30).
Humalog and Novolog are more potent than regular insulin, so the dose is about 2/3 of the regular insulin dose
"Only a few of the 20 available [home glucose monitoring] machines are suitably accurate for our purposes." "None are suitably accurate or precise above 200 mg / dl [11.11 mmol / l]."
Vitamin C in doses over 250 mg interferes with fingertip glucose monitors. Later he says doses about 500 mg of cause falsely low readings.
He prefers regular insulin (45 minutes before meal) about Novolog and Humalog, because of its five-hour duration of action.
Insulin users need to check glucose levels hourly while driving.
His personal basal insulin is 3 units Lantus twice daily.
He urges use of glucose (e.g., Dextrotabs) to correct hypoglycemia.
He says hypoglycemia is weird on his regimen.
He has an entire chapter on gastroparesis.
His recommended eating program in a nutshell:
Some similarities to the Atkins diet, which he never mentions.
No simple sugars or "fast-acting" carbs like bread and potatoes, because even type 2s have impaired or nonexistent phase 1 insulin response.
Limit carbs to an amount that will work with your injected insulin or your remaining phase 2 insulin response, if any.
"Stop eating when you no longer feel hungry, not when you're stuffed."
Follow a predetermined meal plan (each meal: same grams of carb and ounces of protein)
Six g (or less) or carbs at breakfast, 12 g (or less) at lunch and evening meal. So his patients count carb grams and protein ounces.
Supplements are not required IF glucoses are controlled and used in a variety of veggies. Otherwise you may need B-complex or multivitamin / multimineral supplement.
Recipes are provided.
His has four basic drug treatment plans, tailored to the individual. They are outlined in the book. Dr. B provides detailed notes on what he does with his personal patients.
Overall impressions:
Too complicated for most, and they will not give up higher carb consumption. It requires a high degree of commitment and discipline. In fact, I've never had a patient tell me they were on the Bernstein program.
If I had type 1 diabetes, I might well follow his plan or the Diabetic Mediterranean Diet, NOT the high-carb diet recommended by the ADA and many dietitians.
And if I had type 2 diabetes? Diabetic Mediterranean Diet first, Diabetes Solution as second choice.
If one can get his hemoglobins A1c down to 5% with other methods, would that be just as good? Dr. B would argue that all other methods have blood sugar swings that are too wide.
Many new ideas and techniques here, at least to me.
He is pretty much reveals his entire program here, which is priceless.
I'm not sure this plan will work unless the patient's treating physician is on-board.
His personal testimony and breadth of knowledge are very persuasive.
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