A program developed by Richard K. Bernstein, MD, for keeping blood glucose levels as close to normal as possible at all times. Dr. Bernstein, who himself has had Type 1 diabetes for more than 60 years, was one of the early advocates of aggressive blood glucose control using blood glucose monitoring. He first published Dr. Bernstein’s Diabetes Solution in 1997, and the book was last updated in 2011.
Following what he calls “The Law of Small Numbers,” Dr. Bernstein recommends consuming small amounts of carbohydrate and taking small insulin injections because they have more predictable effects on blood glucose levels. He points out that food producers are allowed a 20% margin of error in the carbohydrate content on their food labels; this may lead to unpredictable results if you eat a meal high in carbohydrate. For example, a meal that is supposed to contain 60 grams of carbohydrate could be off by as much as 12 grams of carbohydrate. If a gram of carbohydrate raises a person’s blood glucose by 5 mg/dl, the predicted after-meal blood glucose level could be off by 60 mg/dl.
Further, Dr. Bernstein points out that the absorption of injected insulin can be variable and “the bigger the dose, the bigger the variation.” Consequently, he recommends that a single insulin injection never exceed 7 units in adults.
Dr. Bernstein recommends consuming no more than 6 grams of carbohydrate at breakfast, 12 grams of carbohydrate at lunch, and 12 grams of carbohydrate at dinner. He recommends ingesting only slow-acting carbohydrate foods such as salad greens and nonsweet vegetables and avoiding sweets, sweet or starchy vegetables, fruits and juices, milk, low-fat yogurt, grains, pasta, and many types of prepared foods. He advises people to get the remainder of their calories from foods that do not significantly affect blood glucose level, such as meat, chicken, fish and other seafood, eggs, tofu, cheese, whole-milk yogurt, and certain types of high-fiber crackers.
For more information on Dr. Bernstein’s approach to treating diabetes, read his book or go to www.diabetes-book.com. Be sure to check with your health-care team before making changes to your diet or your treatment plan.