This was annual physical with internist. Next ophthalmologists visit is February. He has no problem with weight lifting, my wife had asked me to bring the subject up at the very beginning.

aside: Bernstein lists some eye advantages for one of the diabetes oral meds, also the one my phar. dau. likes. Internist said no for diabetes, the opth. could prescribe it for eyes. They are both very proper about these things.

ps Got through big storm here in the Northwest, no damage to us, no power for six hours. Very noisy, like fourth of July with transformers exploding and doing their thing.

RobLL,

If there is an error, I would choose to err on the side of caution. I am not telling you how to go about doing anything in your life, or being argumentative, just expressing a deep concern.

I would err on the side of caution by using lighter weights, switch to perhaps more aeorobic type exercise, and reduce my exercise frequency just a bit until I find out with certainty the status of my retinopathy and its cause.

good luck to you and please use caution if you're not absolutely sure. An internist, as well informed as he may be is not the person with whom I would trust my eyesight to.......

Cajunboy47

Hi Rob,

Do you use your internist to treat your diabetic needs or is he also treating your for other issues? I use an Endo doctor for my diabetic needs and wondered if I needed to do that.

Opth. is the one who said weight lifting is OK. Internist is the one who keeps track of blood sugar. I should have my A1Cs in just a few days. If they are as low as he is expecting I will be pretty happy. He told me my last one's were 5.3, I thought it was 5.7. I'll post them when they come.

Hey Rob,

I think 5.3 is pretty good. Are you now expecting to be lower then the 5.3?

My last A1c was 5.8 and I'm happy with that since it was 9.0 - 9 months ago.

Due to surgery I wasn't able to be as mobile as I should have been but now that I'm getting better I've started to walk daily. For me, exercise has made the difference. In the next few weeks I'll be starting some type of weight training - I hear that will help tremendously with bring down glucose levels.

Good Luck!

The Berstein book recommends stabilizing glucose levels at 85, and A1C between 4.3 and 4.7. I understand his rec. are radical, and not part of mainstream. I was visiting with someone yesterday who was happy with readings of 180 daytime after eating, and A1Cs of 8. He goes to a University endo guy.

Outside a couple Bernstein observations I listened, and did not say anything that could have been a challenge to his way. But this is a "Bernstein" forum, and would be interested in what others have to say about his BGL and A1C recommendations.

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Somehow I have a feeling my comments have some unstated assumption, and I read your answers as also assuming things most of you know, and that I don't know. That said, comments so far really have been helpful. They have answered a lot of questions, but not all. Hence a thank you.

Here is my unstated assumption: Dr. Bernstein asserts that a good sugar reading is 85, and that a good A1C is 4.3 to 4.7. From that I have assumed that my otherwise OK FBG of 105 is no longer close enough to be considered healthy? Ideal?. Likewise my 5.7 A1Cs (actually last one was 5.3) should no longer be considered good, indicating according to Bernstein that my average -BG was 120. So my assumption is that half the time it is over 120, and half the time below. Or perhaps some other combination. The upshot of this is that I considered that I might be a type 2 diabetic, not very, and with a lot of good insulin metabolism, but not ideal, and perhaps declining.

I am not positive that Dr. Bernstein would agree with my analysis, but I suspect he would. What is coming clear to me is that many (some?) of you do not agree with my analysis. I do not have a problem with that. I am searching for information. And taking it all in. It would be useful for me to know if this site generally does not think that Bernstein is right.

Some possibilities:
-Bernstein was the first to popularize going back to very low carb.
-Bernstein went too far in his recommendations.
-Bernstein is right, but his recommendations are too difficult for most people.
-Modern medicines are much better, and allow for more carbs than he recommends.
-I suspect all of us on this forum say far stricter carbs than ADA.

If Dr. Berstein is stricter than the science justifies that means that tomatoes, a little low carb fruit, carbier nuts, a little bread or other grains, legumes are OK. I would love to justify those sorts of additions to my diet. I have not excluded all of them, but I am considering it. My QN, where, ideally should be FBG and A1C be. I would enjoy reading the debate on the issue here or on another forum. I don't get emotional or enraged about differences of opinion.

Thanks for reading this convoluted and long post Rob

Most labs don't even have 4.3 as low limit , and range starts with 4.5, at least, or 4.7! Few years back FBG < 140 was non-diabetic and H1C <6. Now,the trend is towards lower numbers, so FBG before was <110 and now is <100 to be consider normal.
But for Dr.B these number would be warranting eating almost no carbs and if diet alone does not get you in this range, then meds and/or insulin are in order. Personally, I have tried many times to follow the recommended diet 9qwithout meds), and every time my FBG will spike even higher.
For what I have read, as long as Bgs stay below 120-140 in general, the damage to eyes and kidneys is minimized. I got my best number as 5.2% and the higheest was 5.7% (upon diagnosis), so I am happy to be in this range and being able to eat some low GI fruit, some legumes, nuts, yougurt and in general, don't go crazy with my diet. Figured that it is not possible for me to achieve 83 or 85 around the clock, I can only get these numbers later in the afternoon and before dinner. I also don't think that T2 can accomplish the same tight level of control without meds or insulin as T1, but it is JMO.

Well, I think that H1C 5.3 is pretty good and many T2 would kill for this number, but there is also one factor as age, so despite the fact that there are some very insulin sensitive middle age and beyong folks, the majorityof population does become IR as they get older. Also, compare your H1C with recommended by ADA to be <7%
My take on this- do my best without driving myself insane over every single BG spike. H1C is not an average Bgs per se, but factor of BG and time as well, so if you do spike a little, but then Bgs return within 2 hours back to normal ( for me is <100), then it is not too bad in my book and won't impact H1C too much. BTW, normally everyone should see small spike after a meal, it is indication that you don't have huge amount of insulin circulating in your system at all times, "Life without bread" By Dr.Lutz explains it better. healso explains that older folks should not cut the carbs beyong 72 g a day, and I think it is pretty resonable, if you think it is a life time solution.

#1- Bernstein definitely not a pioneer in treating diabetes with very low carb diet, it was known and used long before the insulin was discovered back in 1930s, and OHA avaialbe few decades. So it is old news... There is also a book by W.Bantingfrom mid 19th century, Letter of Corpulence, when low carb diet was used to treat diabetes and obesity.
http://www.supermarketguru.com/Downloads/Banting.pdf, Threr was also Dr.Atkins diet book back in 1970s, so there we go.
#2 - Couldn't agree more with this one, but it is a personal choice. Striving for better control is always a benefit, but trying to achieve constant BG of 83 is hardly possible even for non-diabetics, only to think that Dr.B states that BGs should be at this level before, during and after meal makes it hardly possible IMHO;
this leads us to #3, which is linked to #2, but again, ppl resort to using insulin just to get the magic #, which I think is a bit extreme;
#4-I won't say that modern medicine is much better, not sulfo-meds for sure, but certain recent medications already available and still in works, look very promissing. However, there is no free lunches, so every medication (even endorsed by Dr.B) has nasty side effects, and may pose problems on it's own.
IMO, there should be a balance between efforts to achieve good control and stressing and obsessing about BG numbers. Certainly, I won't deliberately compromize my control by eating starches, grains, God forbid regular sugar and sweets. But avoiding fruits in general, and even tomatoes and tomato products, spitting food to see if there is any glucose in it, using insulin injections to get from <100 to 83, does sound too extreme and rather too stressfull to me.
I still think if a person has only one leg, getting a prostatic leg may help to get around and look somewhat normal to other ppl, but he will never feel the same as when he had both his legs attached, yet achieve same level of fitness as normal person. Same with T2, we can achieve good control, may be better than those not yet Dx with diabetes and eating regular (high carb ) diet, but just the fact that this condition presents, chasing a magic number by eating practically no carb and using insulin and have super low H1C will still not be the same as being non-diabetic in general.
Again, I am not advocating ADA diet, but not a gang-ho with Dr.B plan either, at least, after almost 5 years of trying. I did not found it neither practical nor necessary to stay on 30 g carbs forever, and even when tried could not achieve his goal.


I can't ditch tomatoes, those my favorite veggies (well I have learned for some bizare reasons they called fruit now days, LOL), same way I love yougurt, nuts, other low GI fruits, and eat them without huge spikes in my BGs. I can tell the difference between fruit and bread or cereal, so I manage to keep H1C in <6% club. Cosider, my diet was never too high in carbs even before, I am happy when I have certain variery in my food and have decent numbers. IMO, adding insulin to a very low carb regimen may make my numbers look good on paper, but in long term won't make me healthier. I think H1C <5,5% is good enough for helathy folks, and fasting BGs are most fo the time linked to DP and is by far the hardest number to control!
Frankly, I see similarities in using low fat diet and statins medications in treating high cholesterol , where trend is towards lower and lower numbers every day, while it is hardly achievable without meds, and in long term does more harm that higher CHO itself. For me it is the same as living life in ketosis and using insulin to achieve Bgs of 83 around the clock.
This is just my opinion on the subject, so good luck figuring what works for you.
Edited to correct some typos and add link

Dina - good post. What is particularly informative is how your "philosophy" and experience interacted. It is important to me that I deal with reality. Models (i.e., Bernstein) of control are useful, but are not themselves reality. This is my one disagreement with my doctor, he doesn't think I need to do any testing. I think I should see what my readings are for about a week, and then do spot checking (one or two readings a week) after that.

Interestingly, this is what he wants me to do with blood pressure. Just before dr. visit I test BP three or four times a week. I sit down and immediately take it, then every few minutes until it stabilizes. He likes that system. (Dr. Berstein recommends the same). Otherwise I take it a couple times a month.

I do think it is a reality for very few zealots, who dedicated their life to achieve magic number. But I used to participate in Dr.B's forum, and stopped posting after a year or so. But then I received e-mail from the forum administrator notifying that one member had passed away from a massive ischemic stroke. He was in his mid 50s, followed very low carb diet for almost 10 years living on sausages and shrimps with a small addition of green beans, used meticulous insulin injections. Poor Iceman, he lost more than 50 pounds, was doing great and still died at early age. His numbers were very good and H1C <5% I recall. Enough sad. There could be other factor than just diabetes per se, but indeed it shows that great number intself does not protect from an early death!

I am kinda with your doctor, consider your numbers, but if the doctro objects, invest in a glucose meter (it last a life time) with enough strips for a couple of weeks, but trust me, checking Bgs is sort of addictive and is habit forming, LOL. So you may find yourself on the hook after 2 weeks, and start buying more strips, LOL


BP is something you need to monitor daily, and it is not cost effective. However, both Bg and BP change on horly basis, so makes sense to check it when you are at rest (upon arising) and later at night, before bed. My DH has inheritted tendency to higer BP, so he checkes it twice a day.
Again, with BP it used to be good enough for systolic :100+age, now everyone should be below 120/80 regardless of age.
I see trend with everything: lower the number, and get another patient. More business for doctors and more profitsto Big Pharma. But I prefer to stay away from medications as long as possible, since we know the cure can kill faster than desease itself.
Best regards and good luck with rethinopathy!

From my understanding, those are "optimal" readings, targets to strive for if one can, since normal/optimal is associated with the least risk for complications and damage over time. If someone with type 2 can hit an A1c of 5.3 or 5.5 or even 6.0, and it's with diet and/or medication, I don't think anyone would be complaining or saying that's not good enough - the data clearly shows it's better to get an A1c at or below 6.0 than just to the ADA target of <7.0.



Your FBG is in the pre-diabetic range - ideal? No....ideal is "normal" and 105 is not normal blood sugars in the fasting state. Sorry if that's just blunt, but it is what it is.

Healthy? Probably not in the long-term since glycation is part of the problem with higher blood sugars and what leads to many of the long term complications associated with high blood sugars.



Hey, most T2 would kill for an A1c of 5.3 or 5.7 - that is good control whether it's with diet alone or diet with medication. Is it "optimal" or "ideal" - no, but it's way better than the target set by the ADA of <7.0 since lower levels are associated with less complications...so if your goal is long-term risk reduction, keeping your A1c at, or trying to get it lower, is the way to go.



For diabetics, he's probably the one who's been most vocal about returning to an effective dietary approach that was the treatment of choice before the discovery of insulin and various medications.



I'd have to ask, how so? He advocates that diabetics be told the truth about high blood sugars, the damage they cause, and that they deserve normal blood sugars.



Now we're talking about a whole 'nother issue - what works versus what one is willing to do to achieve blood sugars as close to normal as possible. Which leads directly to "Modern medicines are much better, and allow for more carbs than he recommends." which in some ways is kind of accurate - having modern medicine does indeed offer more options and somewhere to go if diet alone isn't having the same punch it used to in time....but I suspect the idea that they're "better" because they allow more carbs than Dr. B recommends is wishful thinking - if you look at the data from studies where carbohydrate is restricted and compare it to data where medication is the choice, the A1c and other risk parameters are lower (thus better) in the diet when the diet is followed properly. I think this tends to be because we want to believe the medication is solving the problem - but it's not, it's only aiding the body in a small way to deal with carbohydrate turning to glucose in a metabolism where glucose metabolism is impaired...the solution is to limit the carbohydrate, thus lower the glucose excursions, thus lower the potential for complications - medication doesn't do that.

That said, if someone absolutely finds they cannot adopt a carbohydrate restricted diet and faithfully follow it, medication is absolutely their next best option....but again, targets should be lower than the current ADA <7.0 (if you ask me).



Coming from the perspective of what does the data tell us? Well, carbohydrate restriction works and works better, faster and more consistently than anything the ADA is recommending right now.



Probably, at this point, your best bet is to learn how various foods affect your blood glucose levels - as they say "eat to your meter" - good advice for anyone who feels they'd like to tweak their diet to fit their tastes and likes/dislikes. It's an effective way to measure how any food or combination of foods make your blood sugars rise, and how much. Low-GL fruits like berries are often included in diets for those with T2 - you can't go and eat cups of them, but a small amount is doable by most people if they include some fat/protein with them (think yogurt or some cheese).....same with tomatoes or legumes, although you'll be hard pressed for bread or other grains/grain foods, but options exist and it all comes down to testing to see what a food does to your blood sugars and how eating various foods in combination with something you like may allow you to have something.

Optimal numbers - from everything I read, I would say....

FBG....between 80-90mg/dL

A1c.....below 5.5 if at all possible, 6.0 being the high upper tolerable target to try for

1-hour post prandial....up to 140mg/dL

Hope this helps!

To ReginaW:
Are you a diabetic?

No - does that matter?