(milligrams perdeciliter). Blood glucose values in thisbookareasa rulegiven in mg/dl. Ifyou should need totranslate from onetotheother, 1mmol/1 = 18 mg/dl.
My Lifewith Diabetes xvii
sulin regimen to see whatthe effect would be on my bloodsugar.
If a change brought an improvement, I'dretain it.
If it madebloodsugars worse, I'd discard it.
I discovered that 1 gram of carbohydrate raised my blood sugar by 5 mg/dl, and Vi unit of the old beef/pork insulin loweredit by 15mg/dl.
Within a year, I had refined my insulin and diet regimen to the pointthat I hadessentially normal bloodsugars around the clock.
Af ter years of chronic fatigue and debilitating complications, almost overnight I was no longer continually tired or "washed out." People commented that my gray complexion was gone.
After years of sky- high readings, my serum cholesterol and triglyceride levels had now not only dropped, but were at the low end of the normal ranges.
I started to gain weight, and at last I was able to build muscle as readily as nondiabetics.
My insulin requirements dropped to about one-third of what they had been a year earlier.
With the subsequent development of human insulin, my dosage dropped to less than one- sixth of the original.
The painful, slow-healing lumps the injections of large doses of insulin left under my skin disappeared.
The fatty growths on my eyelids from high cholesterol vanished.
My digestive problems (chronic burningin my chest andbelching after meals) and the proteinuria thathadsoworried me eventuallyvanished.
Today, my results from even the most sensitive kidney function tests are all nor mal.
I recently discovered that even the calcified muscle liningthe ar teries in my legs has normalized.
As chief of the peripheral vascular disease clinic of a major medical school, I had been teaching physi cians that a cure for this Monckeberg's atherosclerosis wasimpossible.
I proved myself wrong.
My deformed feet, the droopy eyelids, and the lossof hair on my lowerlegs are not reversible and stillremain.
I hadthe new sensation of beingthe bossofmy own metabolic state, andbegan to feel the same sense of accomplishment and reward I had in engineering when I solved a difficult problem.
I had taught myself how to make my blood sugars whatever I wanted them to be and was no longer on the roller coaster.
Things were finally under my control.
Backin 1973,1 felt quite exhilarated with my success, and I felt that I was on to something big.
Since getting the results of my computer search, I had been a subscriber to all of the English-language diabetes journals, and none of them had mentioned the need for normalizing blood sugars in humans.
In fact, every few months I'd read another article saying that blood sugarnormalization wasn't even remotely possible.
How was it that I,
xviii My Lifewith Diabetes
an engineer,had figured out how to do what was impossible for med icalprofessionals?
I wasdeeplygrateful forthe fortuitous combination of events that had turned my life, my health, and my family around and put me on the right path.At the very least, I felt, I was obliged to share my newfound knowledge with others.
Millions of "ordinary" di abetics were no doubt sufferingneedlessly, as I had.
I was sure that all physicians treating diabetes would be thrilledto learnhow to so easily prevent and possibly reverse the grave complications of this disease.
I hoped that if I could tell the world about the techniques I had stumbled upon, physicians would adopt them for their patients.
So I wrote an article detailing my discoveries.
I sent a copy to Charles Suther, who was then in charge of marketing diabetes products for Ames Division of Miles Laboratories, the company that made my blood glucose meter.He gave me the only encouragementI received in this new venture, and arranged for one of his company's medical writ ers to edit the article for me.
I submitted it and its revisions to many medical journals over a pe riod of years , a period during which I was continually improving in health, and continually proving to myself and my family, if to no one else,that my methods were correct.
The rejection letters I receivedare testimony that peopletend to ignore the obviousif it conflictswith the orthodoxy of their earlytraining.
Typical rejectionlettersreadin part: "Studies are not unanimous in demonstrating a need for 'fine con trol'" (the New England Journal ofMedicine), or "How many patients would use the electric device for measurement of glucose, insulin, urine, etc.?" (Journal of theAmerican Medical Association).
As a matter of fact, since 1980, when these "electric devices" finally were made available to patients, the worldwide market for blood glucose self- monitoring supplies has come to exceed $4 billion annually.
Look at the arrayof blood glucose meters in any pharmacy and you can get an idea of just how many patientsuse, and will use, the "electricdevice." Trying to coverseveral routessimultaneously, I joined the major lay diabetes organizations, in the hope of moving up through the ranks, where I could get to know physicians and researchers specializing in the disease.
This met with mediocre success.
I attended conventions, worked on committees, and became acquaintedwith many prominent diabetologists.
In this country, I met only three physicians who were willing to offer their patients the opportunity to put these new meth ods to the test.
My Lifewith Diabetes xix
Meanwhile, Charlie Suther was traveling around the country to university research centers with copies of my unpublished article, which by now had been typeset and privately printed at my expense.
The rejection by physicians specializing in diabetes of the concept of blood sugar self-monitoring, even though essential to blood sugar control,wasso intense,however, that the managementofhis company had to turn down the idea of making meters available to patients un til many years later.
His company and others could clearly have prof ited from the sale ofblood glucose metersandtest strips.
However, the backlash from the medical establishment prevented it on a number of counts.
It was unthinkable that patientsbe allowedto "doctor" them selves.
They knew nothing of medicine, and if they could, how would doctors earn a living?
In those days, patients visited their doc tors once a month to "get a blood sugar." If they could do it at home for 25 cents (in those days), why paya physician?
But almost no one believed there was anyvalue to normalblood sugars anyway.
In some respects, blood glucose self-monitoring still remains a serious threat to the incomes of many physicians who specialize in the treatment of the symptoms of diabetes and not the disease.
Drop into your neigh borhood ophthalmologist's office and you will find the waiting room three-quarters filled with diabetics, many of whom arewaiting for ex pensive fluorescein angiographyor laser treatment.
With Suther's backing in the form of free supplies, by 1977 I was able to get the first of two university-sponsored studies started in the NewYork City area.
These both succeeded in reversing early compli cations in diabetic patients.
As a result of our successes, the two uni versities separately sponsored the world's first two symposia on blood glucose self-monitoring.
By this time I was being invited to speak at international diabetes conferences, but rarely at meetingsin the United States.
Curiously, more physicians outside the United States seemed interested in controlling blood sugar than did their American col leagues.
Some ofthe earliest converts to blood glucose self-monitoring were from Israel and England.
By 1978, perhaps as a result of Charlie Suther's efforts, a few addi tionalAmericaninvestigators were tryingour regimen or variations of it.
Finally, in 1980, manufacturers began to release blood glucose me ters for use by patients.
This "progress" was entirely too slow for my liking.
I knew that while the medical establishment was dallying there were diabetics dy-
xx My Lifewith Diabetes
ingwhoselives couldhave beensaved.
I knew also that thereweremil lions of diabetics whose quality of life could be vastly improved.
So in 19771 decidedto giveup my job and become a physician , I couldn't beat 'em, so I had to join 'em.
This way, with an MD after my name, my writings might be published, and I could pass on what I had learned about controlling blood sugar.
After a year of premed courses and another year of waiting, I en tered the Albert Einstein College of Medicine in 1979.1 was forty-five years old.
Duringmy first year of medical schoolI wrote my first book, Diabetes: The GlucografMethod for Normalizing Blood Sugar, enumer atingthe full details of my treatment fortype 1,or insulin-dependent, diabetes.
In 19831 finally opened my own medicalpractice nearmy home in Mamaroneck, New York.
By that time, I had well outlived the life ex pectancyof an"ordinary" type 1 diabetic.
Now,by sharing my simple observations, I was convinced I was in a position to help both type 1 and type 2 diabetics who stillhad the best years of their lives ahead of them.
I could help others take control of their diabetes as I had mine, and live long, healthy, fruitful lives.
The goal of this book is to share the techniques and treatments I have taught my patients and used on myself, including the very latest developments.
If you or a loved one suffers from diabetes, I hope this book will giveyou the tools to turn your life around as I did mine.
Acknowledgments
I would liketo thank the following people, whose aidand guidance made this book possible: Frank Vinicor, MD, MPH, past president of the American Dia betes Association, who took time from his overwhelming schedule to write the foreword.
Stephen Stark, novelist, critic, andessayist, whose suggestions about tone, clarity, and structure were of immeasurablevalue.
Pharmacists Stephen Freed andDavid Joffee, who wrotethe impor tant appendix"DrugsThat MayAffect BloodGlucose Levels." Patricia A.
Gian, dear friend and director of my medicaloffice,who shared the stresses of this endeavor and gave me invaluable aid and guidance all along the way.
Two top-of-the-line professionals, Elizabeth Nagle, my editor, and Channa Taub, my literary agent, whose efforts made this undertaking possible.
Peggy Leith Anderson, copyeditor nonpareil.
Karen A.Weinstock and Timothy J.
Aubert, for the recipes.
Finally, my love and thanks to my wife,Professor Anne E.Bernstein, MD, FAPA, FABPN, who allowed me to steal so much time that really belonged to her.
Dr. Bernstein's
Diabetes Solution
Before and After FOURTEEN PATIENTS SHARE THEIR EXPERIENCES
You're the only person who can be responsible for normalizing your blood sugars.
Although your physician mayguide you,the ultimate responsibility is in your hands.
This task will require significant changes in lifestyle that may involve some sacrifice.
The question naturally arises, "Is it really worth the effort?" As you will see in this chapter, others have already answered this question for them selves.
Perhaps theirexperiences will give youthe incentive to find out whether you can reap similar benefits.