by Andrea R. Isom
On June 30, 2009 one of my worst fears was realized. I was diagnosed with Type II diabetes, with fasting blood sugar of 273 and a Hemoglobin A1C of 9.3 percent. Although, knowing what I know now, in retrospect, I should not have been surprised.
I had sought help for what I thought was a thyroid problem. I could not lose weight. Despite losing the baby weight plus 10 pounds after a second pregnancy fraught with the complications of gestational diabetes and bringing my blood sugars back to normal after her birth, I was gaining weight inexplicably fast. For six months I had been living on a combination Phase II of the South Beach Diet meets Weight Watchers points system, a 90-minute daily cardio routine and a three-day per week strength training routine. Despite everything, within a 10-week period, I gained back the pregnancy weight plus eight pounds. I was exhausted, I could not concentrate and I didn’t understand why my body would not respond to my weight-loss efforts. I am not quite 5 ft. 3 inches and my weight was approaching a very dangerous 200 pounds.
The doctor who diagnosed me was a naturopathic doctor, not a medical doctor, whose nutrition counsel helped me maintain normal blood sugars during my second bout with gestational diabetes. I expressed my shock because no refined sugar entered my body and I only ate whole grains plus my calories were restricted. She explained that even so, that was more carbohydrate than my body could metabolize, and that recent nutrition research indicated that diabetics should not eat more than 30 grams per day for optimum health. When I asked how on earth would I get my 5-7 servings of fruits and vegetables in for health, she explained that 30 grams of net carbohydrate (i.e. not counting fiber) is equivalent to 15 ½-cup servings of cooked spinach, 60 cups of raw spinach salad (and other greens) and seven servings of broccoli, which would allow for vegetables, but unfortunately very little fruit.
She prescribed Metformin, ER and told me to read Dr. Bernstein’s book and follow his diet. She referred me to an endocrinologist (a 10-week waiting period) and told me to visit my medical doctor immediately to start an insulin regimen as soon as possible. I bought both The Diabetes Diet: Dr. Bernstein’s Low-Carbohydrate Solution and The Diabetes Diet: Dr. Bernstein’s Low-Carbohydrate Solution and read them in two sittings. I started following the nutritional advice immediately. Within 12 hours of starting my fasting blood sugar had come down from 273 to 220 before I started the Metformin. Within four days, fasting blood sugar was under 200 and a week later, the day I saw my medical doctor to receive insulin, it was 153. With low doses of insulin, I brought my fasting and after-meal blood sugars within a normal range within two weeks. After three months on Dr. Bernstein’s program, my A1C was 6.1, the cut off for diabetes. Within six months I reduced it to 5.5.
The medical doctor, who prescribed the insulin while I was waiting to see the endocrinologist, is a practitioner of Internal Medicine and not Endocronology, said that insulin would make me gain weight and I’d need to follow the diet promulgated by the American Diabetic Association. She also told me not to keep “tight control” of blood sugar so that I wouldn’t pass out in a bout of hypoglycemia. She suggested that I not try to lower it below 140. Thankfully, I heeded Dr. Bernstein’s advice, took her with a grain of salt and followed his plan for eating, insulin dosing and preventing hypoglycemia while maintaining healthy glucose control.
As Dr. Bernstein notes in his book, insulin doesn’t make you gain weight, uncontrolled blood sugar fueled by a carb-heavy diet does. I was advised not to exercise until fasting and post-meal blood sugars were below 173 to reduce strain on the heart and to avoid high blood pressure. To my great surprise I lost 5 pounds within the first week without trying. I lost 10 pounds the first month. After nine months, I have lost 30 pounds and two dress sizes. My waist is five inches smaller and I’ve lost my double chin. Best of all, I no longer have to shop at plus-size stores.
Usually when people are diagnosed with diabetes, they are required to attend “diabetes education” programs, co-sponsored by hospitals or HMOs and the American Diabetic Association. You learn to give yourself insulin injections and you are taught to follow an insane carb-heavy, portion controlled, low-fat diet. Because I had diabetes education with my first bout of gestational diabetes, I did not need to attend it with the type-II diagnosis. I knew to stay away from the ADA diet, not just because of Dr. Bernstein’s advice but because when pregnant, my first meal following the ADA diet, with 30 units of insulin was also, my last. My first meal on the ADA plan was breakfast: I had a ½ cup serving of whole grain cereal and 1 cup of skim milk. I was not counting carbs. My blood sugar skyrocketed from 153 to 460. I was taken to the emergency room. I explained to the perinatalogist that I was following the ADA diet advice and he said that is still a huge carb hit. You need to eat protein, good fat and non-starchy vegetables if you want this baby to be born healthy and for me to survive pregnancy complications. “I don’t care what the ADA says,” he advised shaking his head. “You eat what primitive man ate—no grain, except pure fiber.”
I did stay overnight at the hospital for observation, I was given the ADA diabetes diet rather than the regular menu because my condition was “gestational diabetes.” The regular menu consisted of eggs, turkey sausage, toast and a fruit cup and a choice of beverage. My meal was ½ cup of apple juice, 1 cup skim milk, one white-flour pancake with “lite syrup,” egg beaters—a whopping 50 grams of carbs. I explained to the nurse that my perinatologist just told me not to eat this and she said, oh don’t worry, we’ll just compensate you with more insulin. What? I refused to eat the starch, demanded turkey sausage and regular eggs and told the nurse to feed me a regular menu and I’d just pick and choose for myself. I was told that my doctor would have to approve it at which point I called him and told the nurse that was ludicrous, I was trying to follow his orders by demanding a different food choice and if she didn’t comply, I’d have my own food brought in, no one has the right to tell me what I can and cannot eat.
I was angry. Even at the time, I knew enough about nutrition to know that whole wheat is better than white because the fiber would not be absorbed of and I was stunned that a physician would tell me what to eat and the hospital wouldn’t comply. I was a reporter by profession and I wanted to get to the bottom of why a physician would give me nutritional advice that the hospital wouldn’t follow. I called the hospital dietitian and demanded to know why they would feed a diabetic pure sugar for breakfast. She was confused and repeated what I had been served. I re-phrased the question: Why would you feed a diabetic simple sugar, starch in the form of white flour, sugar syrup, peeled processed fruit in sugar and sugar in the form of lactose. She explained that the ADA diet, is calorie restricted and the “starch portions” are bigger when white flour is used, which is usually more satisfying to diabetic patients.
The lunch I refused to eat was a turkey hoagie with mustard, no mayo, peaches in “lite syrup,” skim milk and sugar-free Lorna Doone Cookies. By dinner the situation was remedied because I had ordered in a salad from a nearby deli. Just to note, the nurse did not call the perinatologist because I asked that the menu be changed but because I started ordering in food and was “refusing medical advice.” He set the record straight and from then on, I picked and chose from the regular menu.
I was stunned. How could only one physician know how to care for me but the rest of the hospital was so totally blind to the fact that consuming SUGAR RAISES ONE’S BLOOD GLUCOSE?
I wish I had read Dr. Bernstein’s books back then. His guidance explains how to tell the hospital what to feed you, how to administer your insulin and how not to be put on a glucose-drip IV. He also explains that the diet advice given to diabetics is not based on science, but rather, a political agenda. He explains how to take control of your blood sugar, manage your visits with your diabetes caretakers and how to enjoy eating again. I no longer crave foods that are bad for me, sugar is a literal addiction and I don’t feel deprived. As he says, you don’t need to suffer from the horrible complications of diabetes by taking control of your food intake and nutrition.
In addition, while reading his book, I strongly suspected that I had an undiagnosed case of PCOS, an underlying condition that strongly increases a woman’s chances of developing diabetes. It turns out I did. Most people assume that being fat gives you diabetes, however, in my case what was making me fat was also giving me diabetes and no amount of exercise or traditional low-fat, high-carb diets would ever resolve it.
After nine months on his plan, I have my health back. I am using lower doses of insulin. I have stamina during workouts, my ocular prescription has improved and I feel better than I have since I was a teenager.
I’d like to close with an anecdote. While I was waiting to see the endocrinologist, I wanted to make sure that she would see eye-to-eye with Dr. Bernstein. I called his office in Mamaroneck, NY to see if he had like-minded colleagues in the Portland, Oregon metropolitan area. He answered the call himself. Although, he didn’t, he explained that he had many patients whom he saw only once a year and treated them via email. I explained my insurance situation and he graciously and willingly offered to answer my questions on the spot, free of charge.
Dr. Bernstein shares his wisdom and has a series of monthly teleconferences accessible online at askdrbernstein.com.
Andrea R. Isom is a professional writer and financial analyst who lives in the Portland, Oregon metropolitan area. Her writing has appeared in US News & World Report: America’s Best Colleges, International Treasurer, The Ithaca Journal and dietetic and medical foodservice trade journals.
Please support Dr. Bernstein’s and other researchers’ work at the Nutrition and Metabolism Society and the Nutrition and Metabolism journal. 