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.


The Old Man & His Dog said...

Amen! The two of you have provided me with more "good" information than ANY Dr. I've ever seen.

Scott said...

Congratulations! I do think Dr. Bernstein's wisdom is what many in the medical profession have come to adopt, and so his complements are indeed to be appreciated -- few have a more complete (and personal) understanding of diabetes than Dr. Bernstein -- even if they find his prescribed methods a bit too strict to be practically followed all the time!

Tim said...

Wonderful, congratulations!

rfrancis said...

Well, that's so appropriate. Your book has already joined three others (Gretchen Becker's, Protein Power Lifeplan, and Dr. Bernstein's of course) in my must-have set for new diabetics. And what a wonderful irony, since it's from your site I got the list of the three (okay, I already had two of the books, but even so!)

Laurel N said...

Wow, what a wonderful acknowlegement from Dr B. I have read your book 3 times and yesterday lent it to my diabetes doctor to read on her vacation. She had never heard of it and promised me she would read it and make notes for my next appointment. Your book made me lose the guilt and that is a huge thing for me. Congrats.

Jenny said...


I am so happy that my book disposed of the guilt for you, because that was one of my primary goals in writing it.

renegadediabetic said...

Congratulations. Getting a thumbs up from Dr. B is a great honor.

Sorry that I've been busy and haven't yet ordered a copy. I'll have to get on it.

Cindy Moore said...

Congrats! That is one excellent recommendation!!

Precious Leonna said...

That was great I am glad that the book is a success It is nice that the Praise comes from a DR. and it proves that the books really help him.
precious anderson

Nicky said...

Heh - way to go, Jenny, what a vindication - you deserve it! FWIW, I find myself quoting you more often than Dr Bernstein; I think we owe both of you (and Gretchen Becker, and Jennifer) a HUGE debt.

Cindy Moore said...

I'm here to order another book....2 in fact. One for my sister and one for my niece. I'm keeping mine!

Anonymous said...

I ordered two copies gave one to my sister. And last Thursday, based on the ACCORD paper, my doctor wants all of his patients to have an A1C above 6. Somehow, Jenny, I do not think I will be able to get him to read your book. Rob

Jenny said...


Sounds like you need a new doctor.

Does he know that ADVANCE showed that 21% decrease in kidney disease and NO excess deaths at the lower A1c and that it was a larger study?

Paul T. said...

Jenny- I just discovered your websites and the information is so refreshing, I am learning a lot. I have seen so many endicronologists over the years and they all have widely differing opinions on treatment, I can see where doing one's own research is vital. Most of these guys are too lazy to read and learn.

To give you an example of my situation, I was on a combination of glyburide/metformin for years.. and I don't think I had great control. The dose was twice a day (2.5mg/500mg)and I only tested in the morning.. fasting. Sometimes.

The Metformin was stopped due to my kidneys only banging about 50% (creatanin at about 2.38). I was put on Januvia, once in the AM and Glyburide, once in the AM. I noticed much better control with not the large swings up to 200+ after meals.

The glyburide was recently stopped in favor of Amayrl 1mg once before morning meal. Supposedly because it was more short lived and less chance of very low blood sugar (which didn't happen often anyway).

To give you an example of my current situation, I ran a test this morning..

6:30 Awake.. fbs 106

8:00 took medicines..januvia plus my heart meds

8:45 Eat.. 1 cup fiber one cereal, 1/2 banana, 1/2 cup skim milk. Also took Januvia.

I began the test.

8:50..5 minutes after eating.. 104
9:10.. 161
9:45.. 161
10:15.. 170
10:35.. 157
10:45.. 155
11:05.. 140

so as you can see, I still have a long way to go in order to get the kind of control that I am learning about through your information.

Thank you for being there.

rich said...

paul -

couple of points

you are getting a big hit of carbs for breakfast, and breakfast is the worst time for diabetics to handle carbs, (even non-diabetics)

You might want to ditch the breakfast cereal, banana, skim milk - each of which is quite high in carbs.

Replace that breakfast with perhaps scrambled eggs and cheese, or perhaps some protein (fish, chicken, etc.) from prior day's meals? If you want fruit, you are better off sticking with the berry family.

Lastly, being on a sulfonylurea (such as Glyburide) is not good for the heart - low-dose insulin would be a better alternative (assuming you control your carbo intake).