Author Interview: Little, Brown and Company and...

Little, Brown and Company and The Talk City Network are proud to present our special guest for tonight ---- Dr. Richard Bernstein ---- a true pioneer in developing practical approaches to controlling this devastating disease, and the author of, "Dr. Bernstein's Diabetes Solution,"

Question: Welcome, Dr. Bernstein, we're glad you're here!
Dr. Bernstein: Well thank you! I am happy to be here!

Question: How long has diabetes been known for the disease it is instead of as "something else"?
Dr. Bernstein: The ancient Egyptians described people melting away to sugar water and that was pretty accurate, so I guess they knew what it was then. They probably did have a name for it but I forgot my ancient Egyptian.

Question: What other drugs are there besides insulin which work for diabetes, or are other drugs just for other symptoms?
Dr. Bernstein: There are many drugs that can be used to lower blood sugar. There are about 10 different oral hypo glycemic agents available in the USA. There are also several non-prescription products that are sold for this purpose. But the epitcacy of those has not been quantified. That means, no dose-response evidence published.

Question: How did you come upon your revolutionary method for normalizing blood sugars?
Dr. Bernstein: I was Research Director of a company that made clinical laboratory equipment. After having poorly-controlled diabetes for about 25 years, I stumbled upon an advertisement in a trade journal for an instrument to be used in hospital emergency rooms. It's purpose was to distinguish between unconscious drunks and unconscious diabetics by measuring blood sugar in one minute. I purchased the device for myself on the theory that if I could measure my blood sugars, I might be able to do something about them. That was in 1969. It took about a year to work out a regimen that would keep my blood sugars essentially normal, around the clock. It took about a year of trial and error.

Question: I read a news item that they're working on synthesizing a modified- DNA drug that would eliminate the need for insulin injections. Is this something you've heard of or been involved in? Will there ever be a way to totally eliminate diabetes, do you think?
Dr. Bernstein: No, I haven't been involved, but yes, I do think there will be a way to totally eliminate diabetes. It depends whether one means eliminate or cure. With genetic engineering, it is probably possible to eliminate the onset of the disease by administering the right genes to potentially affected infants. A cure is also possible, by transplantation of pancreatic beta cells. There are numerous approaches to this, but none have yet been successful.

Question: Are there complications from diabetes that used to be taken for granted but are now preventable? What are they?
Dr. Bernstein: All complications are preventable with the attainment of normal blood sugars. This is now relatively easy. Just read my book.

Question: My uncle had diabetes, but my family said it was 'adult-onset diabetes'. Is that the same as regular diabetes, and if not, what's the difference?
Dr. Bernstein: I never heard of regular diabetes. There are several types of diabetes: Type One, or auto-immune diabetes of the young; Type Two, or insulin resistance diabetes of maturity; MODY (maturity onset diabetes of use); and ADOM (auto-immune diabetes of maturity)

Question: Do very many people get diabetes later in life, and is that form hereditary?
Dr. Bernstein: About 90 percent get diabetes after the age of 40, and that form is hereditary. The likelihood of developing it can be increased by obesity, low muscle mass and consumption of large amounts of carbohydrates.

Question: Is it possible to have diabetes even if you have been tested and the results are negative?
Dr. Bernstein: It depends on the test. Many diabetics will have a normal blood sugar at some time of the day; therefore, a random blood sugar is not a diagnostic test. The best tests are either a glucose tolerance test or a hemoglobin AIC determination. The American Diabetes Association, however, recommends a fasting blood sugar. The trouble with the latter is that it is frequently normal in Type Two diabetics.

Question: Wasn't diabetes one of those "shameful" diseases that folks didn't talk about way back when, like alcoholism? And, speaking of alcohol, can diabetics consume alcohol or does it cause major problems?
Dr. Bernstein: It was not a shameful disease in my experience. I've had Type One diabetes for 53 years. As for alcohol, it depends upon the kind of alcohol, what it is mixed with, how much is consumed, and whether or not the patient takes certain types of medication.

Question: Is it harmful for diabetics to get pregnant? I am a diabetic and the doctor said it is a risk -- is that true?
Dr. Bernstein: The risk is if blood sugars are not absolutely normal (85-95/mg/dl) at the time of conception.

Question: I have had juvenile diabetes for ten years, and I am hoping to have children soon. What should I expect? My blood sugars are not entirely stable yet.
Dr. Bernstein: I would recommend that you wait until your blood sugars are essentially normal around the clock.

Question: I've heard the term "pre-diabetic". What does that mean?
Dr. Bernstein: It is an old term used to designate a condition called impaired glucose tolerance, or impaired fasting glucose. Both of these conditions are mild forms of diabetes. Impaired fasting glucose designates a fasting blood sugar of greater than 100/mg/dl.

Question: Tell us about the "Thrifty Genotype" and how it connects obesity, diabetes, and carbohydrate craving.
Dr. Bernstein: Throughout the world, there are populations which have been exposed to famine within the past millennium. The survivors of these famines have developed certain characteristics that foster survival from future famines. This cluster of characteristics is called the Thrifty Genotype. They include resistance to the blood- sugar lowering effect of insulin, and a craving for carbohydrates. Under conditions of intermittent famine, the individual will hunt for carbohydrate which is usually scarce even in-between famines, and the consumption of carbohydrates will increase the production of insulin in order to keep blood sugars normal. Since these people are resistant to the blood-sugar lowering effect of insulin, they will make large amounts of insulin to cover a little bit of carbohydrate. Since insulin is the principal fat-building hormone of the body, these people may be able to put on a little bit of fat between famines, to keep them alive during the next famine. This is fine, as long as carbohydrates are hard to come by. When individuals with the Thrifty Genotype are exposed to endless sources of carbohydrates the following events occur -- they make a lot of insulin and build a lot of fat because of the high serum insulin levels. The added fat causes increased insulin resistance. This causes them to make more insulin, thereby making them fatter. The high serum insulin levels also make them hungry, with enhancement of their craving for carbohydrate, so they eat more. As they get fatter and fatter and more and more insulin-resistant, the pancreas has to work overtime in an effort to keep blood sugars in line. The beta cells of the pancreas that make insulin eventually are over-worked and many die. They burn out. With the diminished beta-cell inventory, blood sugars can no longer be controlled. This is called Type Two diabetes. Many cultures that were not exposed to high carbohydrate foods until recently have developed high incidences of adult and teenage obesity, and Type Two diabetes. For example, the Pima Indians who were slim 100 years ago, and had no words for diabetes or obesity, now experience 100 per cent of the population as grossly obese and 60 per cent have Type Two diabetes. Similar statistics apply to the Aborigines of Australia since the introduction of corn and flour by the Australian Aboriginal Service. Such statistics also apply to the Fuji islanders, since the tourist explosion after the second World War. The inhabitants of Fuji now have pizza parlors and fast-food outlets. Many Caucasians with ancestors from Europe likewise have inherited the Thrifty Genotype.

Question: I know that sugar is the big boogie-man of diabetics. What if a diabetic just cut out ALL sugar? Wouldn't that work?
Dr. Bernstein: It's not just sugar. It's all forms of carbohydrate. Furthermore, many diabetics make no insulin. Insulin is necessary to keep blood sugars normal, even when fasting.

Question: So you say not to use carbohydrates as primary diet?
Dr. Bernstein: That's correct.

Question: How does one fight the craving for carbohydrates?
Dr. Bernstein: Many individuals who embark upon a low-carbohydrate diet lose the craving spontaneously. Daily strenuous exercise also helps curb craving for many people. The ultimate solution relates to a U.S. patent that I recently received for utilizing medications that curb carbohydrate craving. The patent involves a method for preventing the development of a tolerance to these medications. Those interested should refer to U.S. patent number 5, 716, 976 - Method of Treatment for Carbohydrate Addiction.

TWBookmark: Dr.Bernstein also has a web page at: http://www.diabetes-normalsugars.com

Question: Re: blood sugar testing -- Best time? Bedtime, before bedtime snack, or after snack and before settling down to sleep?
Dr. Bernstein: It depends upon the type of diabetes that you have. We never recommend snacks.

Question: How can I persuade my 15-year-old son to check his blood sugars every day? He only checks them when he himself is curious or feeling like he has low blood sugar.
Dr. Bernstein: There is little value to checking blood sugars if you don't know what to do about them. Although I invented blood sugar self-monitoring, I didn't do it with the goal of increasing my own frustration.

Question: My husband does not use a high-carbohydrate diet, yet maintains you must check sugar levels more often using high-carbohydrate diet. Is this true?
Dr. Bernstein: Because of some principles described in my book, called the Laws of Small Numbers, it is mathematically impossible to control blood sugars on a high- carbohydrate diet. So it doesn't matter what you do, it's not going to work.

Question: Is it all too inevitable that I may get diabetes if I am 51, 100 lbs. overweight, and my biological father died of diabetes? My blood has always tested more than normal according to my doctors.
Dr. Bernstein: If it is more than normal, then you already have diabetes.

Question: Why do you want "normal" blood sugars for yourself and your patients?
Dr. Bernstein: The grave long-term consequences of diabetes are caused by elevated blood sugars, not by the name "diabetes".

Question: Isn't it "unnatural" for diabetic blood sugars to be at or near "normal"?
Dr. Bernstein: I have been repeatedly told this by physicians for the first 25 years after I learned how to normalize my blood sugars. This is a myth that, for all I know, may still be perpetuated by some members of the medical profession. I was even told this by the president of a state diabetes association in front of a television camera.

Question: Would you please explain why diabetes affect the feet in such a big way?
Dr. Bernstein: For a variety of reasons. High blood sugars cause damage to nerves throughout the body. The longest nerves are affected first. These are the ones that go to the feet. Injury to the nerves that control the shape of the foot leads to a deformity with claw-like toes and a high arch. This shape pre-disposes to pressure from shoes on the knuckles of the toes, on the heel and on the bow of the foot and on the tips of the toes. Under such daily pressure, the skin can break down and form ulcerations. Injury to sensory nerves makes it impossible to feel undue pressure or other injuries to the skin. Therefore, patients will not change to shoes that fit properly because they are not in pain. Damage to the sympathetic nervous system prevents a perspiration in the feet, and they become very dry. Dry, cracked skin is readily injured and slow to heal. Furthermore, the cracks are sites for invasion by bacteria. Poor blood sugar control also impairs circulation, especially in the lower extremities. If there is poor circulation, injuries to the skin are slow or even unlikely to heal. My book contains a list of the same instructions for foot care that I hand to every patient. It appears in Appendix E on Page 360.

Question: Why does the ADA persist in pushing high-carb diets?
Dr. Bernstein: I suspect that this stems from the 1940's, when I was a child with newly diagnosed diabetes. At that time, the relationship of serum cholesterol to vascular disease was elucidated. Since most diabetics had elevated cholesterol levels, it was generally assumed that cholesterol was the cause of the long-term complications of diabetes. In those days, it was believed that high-cholesterol levels were caused by eating fat. So diabetics were put on very low-fat diets. I followed this regimen and my cholesterol went sky high. It was only after I greatly reduced the carbohydrate that my cholesterol plummeted to sub-normal levels. Somehow, the people who write the guidelines for the ADA ignore much of the scientific literature and developments in recent years.

Question: What do you think of the 'Blood Type' diet? Should a diabetic follow it?
Dr. Bernstein: I think it is a waste of time. My patients do extremely well on a low carbohydrate diet, so matter what their blood sugars are.

Question: Tell us about your technique for painless insulin injections.
Dr. Bernstein: The key is speed. You grab a hunk of fat and throw the needle into the skin as rapidly as if you were throwing a dart. It helps to use the new short needles. guest-Jean says: Do you have another book coming out?
Dr. Bernstein: No, I do not. We may one day, work on a recipe book, and on an update of the current book. In the meanwhile, there is a brand new invitation on my webpage for people to submit low-carbohydrate recipes that will be published on the Internet.

Unfortunately, we've come to the end of our chat. Thank you, Dr. Bernstein, for joining us. It's been a pleasure having you here. Any final thoughts you'd like to leave with us?
Dr. Bernstein: Thanks for having me. The key to surviving diabetes is normal blood sugars. These are not terribly hard to attain.

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