Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars [Hardcover]

At age 35, his body was falling apart due to the ravages of blood sugar. He had signs of kidney disease and eye disease and nerve pain in his legs.

Then he discovered how to normalize his blood sugars through the program in this book. Most of his complications eventually disappeared, and he has had no new complications since. His theory (shared by most diabetes experts) is that the complications are due to high blood sugars. But his solution (keeping your blood sugars in the normal range 24 hours a day) is rejected by most doctors, who believe it is too difficult for most people.

The three keys to his program are: A very-low carbohydrate diet - This is the most important part and will probably be helpful even without the other parts. Bernstein prescribes NO sugars, grains, fruits, milk, or starchy vegetables (fast-acting carbs.) He does recommend relatively small amounts of green vegetables and other slow-acting carbs, because of their vitamins and other nutrients. This is not an Atkins-style, no-carb diet.

Frequent blood sugar monitoring to develop your "blood glucose profile." You need to learn exactly how different foods affect your sugars, and how sugars change overnight and with exercise. By checking his blood sugars after each food he ate, Bernstein discovered how carbs raised his blood sugar faster than his injected insulin could catch up. He has you check your blood sugar many times a day.

Frequent dosing with fast-acting insulin or (for Type 2s) an insulin-sensitizing pill, to cover your meals, along with a low dose of long-acting insulin to get you through the night and early morning hours. He recommends insulin even for Type 2's who make some of their own, because he believes the injected insulin will take the pressure off the pancreas and allow it to heal.

If this sounds like a difficult program, you haven't heard half of it yet. He also recommends extremely vigorous, anaerobic exercise. He prefers prolonged weight or resistance training to the point of pain, because building muscle mass helps soak up blood sugar and lessens insulin resistance.

His program also requires you to counts carbs and proteins and calculate your proper insulin dose before meals. He recommends you have as many as four different kinds of insulin for different occasions. He wants you to floss after every meal to prevent dental infections. And there's a lot more.

But is it worth it? In researching my upcoming book, "The Politics of Diabetes," I have interviewed four people who read his book. Two thought it was too hard to try. One stayed with the program for a while and says it helped, but he has slacked off. One woman stuck with it and says it saved her life.

Diabetes experts I have queried are skeptical of how much the ultra-low-carb diet helps. They cite conflicting research and the success many patients have even on a balanced diet that includes fair amounts of carbs.

There is also no agreement on the need to get blood sugars down to "normal" (less than 95, say.) Many docs think getting sugars down to 120 or even 140 will be sufficient to prevent complications in most people. True, but SOME people will get complications that would not have gotten them if they kept their sugars lower.

You have to have some education and a lot of self-confidence to take this on, especially as it may mean educating your doctor as well. There is a steep learning curve, and this program will probably totally take over your life for the first weeks or even months. As you get used to it, it becomes less intrusive, but still much more so than the usual programs your doctor may put you on. It comes down to how important your health is to you, how much time and money you have to devote to your diabetes care, and especially how much support you have.

Bernstein is aware of these difficulties. He consistently advises lower-cost alternatives to various medications and equipment, which makes him one of the few docs or self-help writers to recognize that money is a problem for many of us. But the book is a demanding read - densely packed with valuable information on everything from insulin injection and blood glucose checking techniques to the different kinds of oral diabetes medicines, from what to do when you're vomiting (call your doctor immediately!) to pages of low-carb recipes. The language and style probably work best for people with some college education, although a determined high school graduate could handle it. It also has a number of inspiring testimonials and a good sense of humor.

I think that people who are having trouble managing their diabetes might want to try this program, or at least the low-carb diet part of it. If you want to do the whole thing, this book by itself won't be enough. You will need to get the help of a doctor and probably a diabetes educator as well, and having some supportive family wouldn't hurt.

If you do try it, I support that decision. I'd like to hear how you do with it.

This book is a must for everyone who treats people with diabetes, and for everyone with diabetes.