Wednesday, June 18, 2008

Dr. Bernstein's Letter Recommending Blood Sugar 101

I posted earlier that Dr. Bernstein had written me a very nice letter praising my book, Blood Sugar 101. I wrote back and asked his permission to quote what he'd written and received that permission from him last week.

So here's what Dr. Bernstein had to say about my book:

"Thanks for sending me a copy of BLOOD SUGAR 101. I enjoyed it very much and actually learned a lot of important facts.

"I was impressed by your ability to scour the scientific literature and document your findings.

"I think this book should be read by all diabetics because of the valuable material that cannot be found elsewhere."

I am thrilled beyond words. Simply stated, there is no one in the world whose praise could mean more to me, because there is no one else whose own work has had such a huge impact on my life and health as Dr. Bernstein's has.

I had a terrible time getting a diagnosis because of the peculiar nature of my diabetes--very high blood sugars after meals, normal fasting blood sugar. Without Dr. Bernstein's book I might have gone for years more with the continual UTIs and yeast infections and have developed the heart disease that is endemic in the side of my family that carries this oddball diabetes gene.

But the tools he gave me in his books helped me get to near normal blood sugars, and also helped me understand enough about diabetes and its treatment to be able to evaluate the quality of the medical treatment I was getting.

He broke the way for a generation of people with diabetes--both Type 1 and Type 2--by championing the idea that lowering blood sugars will prevent complications years before that concept was proven by the DCCT, as this 1993 New York Times article makes that very clear: Vindication for a Diabetes Expert

For decades his was the sole voice calling for people with diabetes to cut the carbs, throughout the period when all people with diabetes were told that fat would kill them and the only safe diet for them was one that contained 300 g a day of "healthy carbs"--a diet that raised their blood sugar dramatically after every meal they ate.

Because many people with diabetes find the austerity of the diet that Dr. Bernstein recommends hard to accept, one of the things I set out to do when I did the research that led to Blood Sugar 101 was to learn what the academic research had found about the connection between blood sugar level and complications. This seemed to me the best way to determine if the blood sugar targets that Dr. Bernstein insists on are what is required for health.

My conclusion, based on the data, is that achieving Dr. Bernstein's blood sugar targets probably is ideal--especially if it can be done without using questionable drugs like the TZDs and sulfonylureas, but that true normal probably is a bit higher than what he prescribes. So it is likely that a slightly higher set of blood sugar targets probably confers the same health benefits as his do with the advantage of being easier to achieve for people who do not have personalities that incline them to iron discipline.

Dr. Bernstein addressed this difference between us, too, in his letter, which made his praise all the more valuable to me.

He wrote, "I wish that our guidelines for blood sugar targets and carbohydrate intake were closer together but this is a battle that I have been losing for many years."

But that said, I don't think he's losing that battle at all. I think his shadow lies over a whole generation of us who have learned how our blood sugar rises when we eat carbs, who use basal/bolus regimens (which he appears to have pioneered), and who are ten years or more past a diabetes diagnosis without having developed the horrible complications that even a decade ago most doctors assumed that we would get.

My book grows out of the revelations that his work provided and without his work, none of mine would have happened.

Thank you Dr. Bernstein.

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