on the train, ride the subway, drive several hours, and not fear one of those low blood sugar episodes.
I started once again to exercise every day.
My stamina seemed to increase.
I didn't have to push hardto ac complish my daily goals at work and at home.
Within a couple of months, I was back to 129 pounds, had gone from size 14 to size 10, and ten months laterto size 8 and 120 pounds.
Even the swelling and pain in my rightknee , arthritis, I wastold , abated.
I feel great.
My self-esteem and self-worth are whole again.
I now take only 8 units of insulin each day, where I had previously been taking 31 units. "I am also conquering my uneasyand frightening feelings about the long-termconsequences ofhaving diabetes.
While I oncethought that heart disease, kidney failure, blindness, amputations,and many other health problemswerewhat the future probably held for me, I now be lievethat they are not necessarily outcomes of livingwith diabetes. "But my life is not perfect.
I stilloccasionally throw caution to the wind by eating too much and eating foods I know are taboo.
Sticking with my diet of no bread, no fruit, no pasta, no milk, seemed easy when it wasnew,but now it is not easy, and loadsof my efforts go into making salads, meat, fish, or poultryinteresting and varied.
My fan tasies are almostalways of some forbidden food , ahot fudge sundae with nuts, or my mother's blueberry cobbler topped with homemade ice cream.
But when allis told, I feel that I am really lucky.
All my ef forts have really paid off."
AD. is a fifty-five-year-old former typesetter whose diabetes was diag nosed fourteen years ago.
As with many other people who use our regi men, his test ofaverage blood sugar (hemoglobin A1C) and his tests for cardiac disease risk (cholesterol/HDL ratio) simultaneously dropped from high levels to essentially normal values. "I watched my mother deteriorate in front of me from the compli cations of diabetes, finally resulting in an amputationof the legabove the knee, and a sorrowful existenceuntil death claimed her.
My oldest brother, who was also diabetic, was plagued with circulatory compli cations that resulted in the amputation of both feet, with unsightly stumps.
Diabetes robbed him of a normal existence. "When I began to experience the all-too-familiar diabetes symp toms,my future looked bleak andI feared the same fate.
I immediately searched for help, but for two years floundered around getting much
Before and After 17
medical advice but not improving.
In fact, I was getting sicker.
My doctor had said, 'Watch your weight,' and prescribed a singledailyoral hypoglycemic pill for my type 2 diabetes.
It sounded easy, but it wasn't working.
My glucose levelswere in the 200 range alltoo often, and oc casionally reached400.1 was constantly exhausted. "I started Dr.
Bernstein's programin 1985.
Sincethen I have recov ered my former vitality and zest for life.At my first visit, he switched me to another approach , a fast-acting blood sugar-lowering pill 3 times a day, before meals, along with a slower-acting pillin the morn ing and at bedtime.
My regimen was totally overhauled to eliminate foods that raised blood sugar, and to reduce greatlymy consumption of carbohydrates in general.
Macaroni and ravioli had been important parts of my diet since birth.
I had to give these up.
I didn't mind a greater emphasis on protein.
I even began to include fresh fish in my diet. "My initialreaction wasthat theserestrictions weretoo high a price to pay, and that I would be unableto continue them for long.
Also, I was askedto check my blood with ablood sugarmeter for aweek prior to every visit to Dr.
Bernstein.
That meant sticking my finger several times a day.
I was willing to discipline myself for a short period in or der to be able to return to a more active, vigorous life and to put my malaise to rest.
At the beach, I was sorely tempted to give up the diet, while watching family and friends eat without restrictions.
But since my body was feeling healthier, I continued with the program.
After about two months, with many dietary slips on my part, I managed to better discipline myself because I sensed it made me feel better.
My glucose level started to descend to 140,130,and finally to 100 or less on a consistent basis. "Dr.
Bernstein also encouraged me to purchase a pedometer, a de vice that clipped to my belt and measured the distance that I walked each day.
I began to walkdaily, holding3-poundweights and swinging my arms.
This was yet another thing to bother with, and I felt it would cut into my free time.
But the resultwas an invigorating high.
By this time, I didn't mind pricking my fingers several times each day, as it showed me the way to better blood sugars.
Fortunately for me, New Rochelle has many beautiful parks.
I choseGlen Island Park because it is nearLong Island Sound and nicelykept.
This meant getting up ear lierin the morning to walk duringthe week,but that was no problem since I am an early riser.
I bought some cast-iron dumbbells for addi-
18 Before and After
tional exercise.
I learned about arm curls, overhead raises, arm circles, and chest pulls.
I didn't realize that there were so many different exer cisesthat you could do at home to benefit your health. "My glucose levels are now consistently within or near the normal range,not at the sorry levels which nearlyput me in the hospital.
That all-consuming fatigue is gone,and I feel that now I'm in control of my diabetesinstead ofthe reverse.
With adherence to the program, I know that I don't have to suffer the same debilitating effects that afflict so many other diabetics."
Harvey Kent isfifty-one.
He has known abouthisdiabetes for approxi matelysixyears, and we suspect that heprobably had it for three tofour years prior to his diagnosis.
He has a family history of diabetes, and his story isfairly typical. "I went in for a routine physical.
I've always had high risk factors , both my parents had diabetes, my brother had diabetes, and my sister has diabetes.
My brother, who was forty-nine, passed away recently from diabetic complications.
My sister, who is fifty-nine, is on dialysis.
When I found out I had it, I felt I was going down the same slippery slope.
I'd been trying to lose weight, but not very successfully.
The doctor I was seeing, an endocrinologist,kept upping my medication.
Everytime I went to seehim, I wound up taking more and more, and my blood sugars weren't going anywherebut up. "I kept having the feeling that as far astreatment went, nothing was happening.
I wasn't in bad shape, but then I watched my brother pass away, and I thought, 'I've got to do something.' "I happen to live in Mamaroneck, New York, near Dr.
Bernstein, and my wife suggested that I seehim forasecondopinion.
I kept won dering, 'Is there another approach?' That's really how it started.
The standard approach was always to tell me to lose weight, to exercise,and to take medication.
I wastrying to do allthose things, but I wasn't hav ing much success at any of them exceptthe taking of medication.
As it turned out, Dr.
Bernstein still said the same three things, but his ap proach to each ofthe categories wasradical, especially on the diet.The diet has been a major factor , I've lost a lot of weight. "Once I started getting a sense of what Dr.
B. was talking about , which was reallyright from the firstvisit; he's very thorough in his ex planations , I kind of figured it out.
Just to demonstrate the effects of diet, he told me to stay on my same diet and measure my blood sugars,
Beforeand After 19
but I startedcutting back on the carbohydrates, so by the time we sat down to negotiate a meal plan, which was maybe the third or fourth session, he just confirmed what I'd already started about a month before. "Before I met Dr.
Bernstein, I'd been under treatment for diabetes by three different doctors.The guy I was seeing before Dr.
B. is an en- docrinologist/diabetes doctor with a fairly large practice.
He never once said to me, 'You know,by controlling your blood sugars, most of these complications are reversible.' When Dr.
B. told me that , well, for a diabetic who's stuck with this disease for the rest of his life, that's niceto hear.
Nobody ever tells you this.
At least I don't rememberany one everexplainingthis to me.
I'vebeen amember ofthe ADA [Amer ican Diabetes Association] for several years, and no one ever said anythinglike that to me, anywhere.
I waslucky.
I hadn't developed that many complications , not like my brother and sister, but I knew how fast they could get you. "With my old doctor, I'dbeentoldto monitor my blood sugars and then come in everythree months.
What it wassupposedto do, I wasn't sure , keep you honest, maybe, but I couldn't figure that out.
I was checking my fasting blood sugars in the mornings.They were averag ing somewhere about 140 mg/dl.
And when I'd go in, the doctor would do blood work, scratch the bottoms of my feet, and check my eyes, then say, 'See me in three months.' The whole thing would take maybe half an hour and then I'd see him again in three months.
I wasn't sure what the whole thing was about.
The thing is , and I found this out with my sister and my brother, it's a slippery slope.
You start out as a type 2 and you get this kind of treatment, and you burn out your pancreas, and beforelong,you're insulin-dependent. "When I saw Dr.
B., he did a very extensivemedical exam and un covered everything there was to uncover.
He checked everything.
He found that I had an anemia, and so we started doing things to deal with that.
I had not had retinopathyor neuropathy.
I had some protein in my urine, a potential sign of kidney disease.
But he said that could be from my old kidney stone,or it couldbe from the diabetes.
He said we'd wait awhile until my blood sugars were normalized, then test again and find out, because if it wasthe diabetes, it should clear up. "The first thing he did was get me off Micronase and onto Glu- cophage.
Micronase is one of those oral hypoglycemic agents that stimulate your pancreas, and he said, 'Why are you doing this?
You're burning your pancreas out quick.' He looked at my blood sugars care-
20 Beforeand After