Friday, January 31, 2020

Why Dr. Bernstein is an American Hero and Why Doctors Should Be Curious About Him

Originally published May 2018

My colleague at Diabetes Daily, Maria Muccioli, Ph.D., wrote an excellent and in-depth coverage of a remarkable study on very low-carb diets for treating type 1 diabetes in children.
The study found that a group of type 1 diabetic children following a very low-carb diet à la Dr. Bernstein style were not only experiencing normal blood glucose levels (this is nearly unheard of in type 1 diabetes) but also growing well (a top concern as macronutrient intake of carbs is widely believed to be essential for growth in children).
The researchers of the study looked at children from a Facebook group called Type1Grit. This group consists of adults with type 1 diabetes and parents of children with type 1 diabetes who all follow Dr. Bernstein’s regimen. This regimen includes very low-carbohydrate intake but so much more–put just any type 1 diabetic on a very low-carb eating plan, and I promise you’ll likely not get the results you are hoping for–though if you pay close attention to blood sugars you may notice some interesting things regarding the statistical range of error after giving smaller amounts of insulin. It’s about more than low-carb eating. Low-carb is essential to the plan but to do well, there are more things to do and understand. One must understand how to use and adjust insulin properly, understand how different physical activity impacts blood sugars, and so on. The Type1Grit group does so well because they utilize Dr. Bernstein’s decades’ long expertise to guide them (which is all in his book) and like any good support group, they help each other stay focused, informed, and motivated.
Some people on social media have voiced strong opinions against the group due to some of their outspoken members. It is my hope that we focus on content over delivery when it comes to important matters. After all, if fellow thinkers had rejected Issac Newton’s findings simply because he was a jerk (and according to the book I’m reading my kids about him he was) wouldn’t that be a shame? Personally, I strive to be gentle with others because I am quite sensitive. However, I also try not to put my feelings above critical thinking, and I think that serves me well. I also hope that the communication of a few doesn’t cause some to dismiss the whole group or worse–a promising idea. That said, I have not personally observed anyone from that group being rude to others, though some have been quite open and blunt with their opinions and I have observed a very strong response to that, in general. I do not consider an opinion shared in a straightforward manner to be rude.

My Personal Story Following Dr. Bernstein’s Advice

I have followed a loose version of Dr. Bernstein’s protocol for about a decade, further lowering carbs and adding in more of his advice gradually over the years (I now follow his advice very closely). His logic struck me like lightning when I read his book, Dr. Bernstein’s Diabetes Solution. In particular, I was deeply moved by a line that said something about how people with type 1 diabetes “deserve normal blood sugars”. Dr. Bernstein’s protocol includes the use of Regular insulin to cover high protein meals versus faster analog insulin such as Humalog or Novolog. In fact, after using a CGM (continuous glucose monitor) for the first time recently, I quickly saw how my Humalog was a bit too quick and potent at mealtime and then a bit too short hours afterward, so I bought Novolin R at Walmart for $24 and have improved my blood sugar levels. This is to stress how following Dr. Bernstein’s protocol is about more than just reducing carbohydrate intake.
Many years ago, I found immense value in attempting just a little bit of Dr. Bernstein’s advice. Small changes like lowering my carbohydrates and understanding how to use my insulin better led my A1c to drop from 8-9% down to 6%. Before this, just covering high amounts of carbohydrates with insulin had mostly succeeded in making me fat, tired, depressed, and anxious (oh and with protein spilling into my urine as an 18-year-old in her “prime” of life). You have to understand how terrible this was for me–I was a bright-eyed kid who was intelligent, hopeful, hardworking, patient, and super determined. In a few short years, diabetes messed with my potential–I didn’t recognize myself anymore. It’s particularly sad to spend years recovering as a young adult when you’re supposed to be at peak performance and potential due to your youth and energy.
Dr. Bernstein, who many dare call a “quack” or “nutjob” saved my life just as he saved his own. My A1c hasn’t touched 6% in many years. I have a wonderful husband. We have twins who are about to turn 9. I’m still trying to reverse some of the consequences of very high blood sugars from my first 10-12 years with diabetes. What if I didn’t have to?

What Actually Does More Harm?

People tell me that eating low-carb will hurt my cognitive abilities. Do they know that studies indicate that typically managed type 1 diabetes may do that, anyway? Type 1 diabetes (with the average management of 8.2% A1c in the U.S.) has been shown to possibly lower intelligence and negatively affect memory and speed. Low-carb in the long-term may hurt my cognitive abilities (I haven’t seen anything to indicate this possibility though) but what if it just takes the place of what high blood sugars would have done to my cognition? And what if low-carb additionally helps protect my cardiovascular health and my kidneys and my eyes–oh and allow me to have healthy children! Do you know how fortunate I am that I turned things around when I did? I have children because of the information that turned my health around just in the nick-of-time. I can’t begin to describe the level of rage I might have had I never had children yet discovered that Dr. Bernstein has been trying to tell the world about his successful method for decades.

Where is Our Curiosity?

If you find Dr. Bernstein followers as angry or overly-passionate, this may help explain why: Unnecessary suffering is a tragedy. We’re in a country whose founders had been curious and open to acknowledging ideas that are worthy, pushing those ideas to the top where they can be put to the test and then accepted as the best ideas because they can create the best outcomes. This is the great thing about Western Civilization. The embracing of objective principles which allow the best ideas to rise because even if they come from someone we can’t stand, we know that ideas, critical thinking, and truth reign over all else and push us towards progress. Dr. Bernstein’s protocol isn’t an expensive training center and it’s not just for the elite of the world. He thrives using a cheap insulin in the same country where people die because they don’t know they can change their dietary habits and purchase cheap over-the-counter insulin in most states and survive.
From an economic and financial viewpoint, Bernstein’s protocol is also a stunning success. I don’t use an insulin pump or a CGM (I only got to test one out) and yet I can achieve my glycemic targets. I don’t need any apps, certified diabetes educators, or expensive technology. I don’t anxiously await a closed-loop hybrid insulin pump system because I don’t need it. I put all my energy into my simple but effective daily lifestyle. Providers who want to see healthier patients, please read Bernstein’s book. Your lower income patients may not want to follow the regimen in part or entirely but those who are willing deserve to know how to thrive with diabetes despite being poor or lower middle class, like me. I give myself excellent care for cheap–doesn’t that peak your interest?
People are justifiably angry over insulin prices but what about the medical community’s unwillingness to be curious about one doctor’s personal plan to keep himself at peak health and fitness well into his 80s? Without curiosity, what on earth then drives a doctor to investigate the issues in each patient as well as find the proper and least harmful solution? I tell my doctor how I managed a huge drop in A1c for the first time in my life and he has no questions regarding how I did it? I read doctor responses to research that shows a teeny tiny improvement in A1c and now they think “this shows wonderful promise and we should look into it further!”? I basically told my doctor I might have just saved my own life and drastically improved my quality of life, and he’s like “meh”. I told another how I did it and he said, “good for you.” Yes, good for me, but what about some of your patients who are as I was, struggling to get a halfway decent hold on their blood sugar and suffering? What about them? Don’t you have an obligation to check this out? This gives my doctor less work, by the way! For a decade now my doctor does nothing to manage my diabetes–he just orders labs. Aren’t doctors wanting more patients that can manage their blood sugars and don’t need them so desperately at all hours?

It Takes “Too Much Discipline” or “Restraint”

Nothing terrible ever happened by being disciplined. Think of all the amazing people out there and from history–what could they have accomplished without discipline? Probably nothing but a few moments of greatness. Discipline encompasses you within a realm of potential greatness. And if you create a system, discipline isn’t a show of willpower as much as you just loyally following your regular routine.
Much research backs up the potential of the ability to defer gratification. Who is more likely to become successful? The person who can restrict themselves from their impulses and short-lived desires, right? Let me put it this way: who would you rather marry? Someone who can keep their impulses in check or someone who can’t? Or who would you rather be? Someone who doesn’t overeat or someone who regularly does? I remember having hearts in my eyes when my husband told me “I never overeat”. I have long struggled with overeating, and when he said this, I was impressed by him and thought, “wow, I want to be like that.” I believe this is the empowered response. I could have given the common humorous response of “ugh, you make me sick” but where would that have gotten me? Instead, I tried to learn from my husband and improve myself.
I also think the healthy response is to admire someone like Dr. Bernstein for what he has accomplished against great odds. Dr. Bernstein is respected by so many because he created a well-functioning system to get himself thriving and generously shared his findings with others. In fact, as an engineer, he became an endocrinologist so that he could help others after he figured out how to save himself. He should be regarded as an American hero, whether you want to do what he recommends or not.
I believe in freedom and personal rights. I’m an immigrant who is incredibly happy to live in the U.S. Growing up when I found something challenging and I didn’t want to face it, my dad would say “Are you an American or an American’t?” I would often roll my eyes but, yes, I’m an American and believe I have the power to set my mind to improve myself if I want and I’m grateful for those who have set their minds to things and laid out paths before me. Thank you, Dr. Bernstein. I may never reach your astounding level of discipline but what I have been able to achieve with your advice has been most valuable to me and my family and I am forever grateful.
En fin, I’m certainly not saying you should do what he does or what I do. And I can respect wherever you are on your journey. I’m saying that Dr. Bernstein’s method has shown undeniably incredible potential and results and the general lack of curiosity and investigation on behalf of the global medical community makes absolutely no sense to me. There are now thousands of people doing it and doing it well.
Newton supposedly struggled with his ego and an inability to face criticism or questioning during his lifetime. Let’s have his overwhelming curiosity without the pride, his determination to dig and experiment properly without his emotionally unstable and anti-social ways.
I will leave you with one more thought:
Just a little bit less damage sustained is a great deal to the person enduring it, especially when they still have many decades ahead of them.

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