In Which I Review Two Books I Thought I Never Wanted to Read

Disclaimer: I paid for these books with my own funds and have not been reimbursed for this review in any fashion. All opinions are my own.

When it comes to what you should eat, people in the diabetes community fall into two broad categories. There are the "eat whatever you want as long as you cover it with insulin" people and there are the "eat only low carb food" people. Of course, I know not everyone fits neatly into one category or another, but most people are closer to one end of the spectrum than the other. We're thoughtful about what Kittygirl eats and strive for a balanced diet and carb moderation, but she doesn't eat low carb by anyone's definition so we're much closer to the "eat anything you want" end of the spectrum than we are to the "eat only low carb" end.

Yesterday I reviewed a book that advocates eating limited carbs, which the author defines as no more than 30 carbs per meal. The two books I'm reviewing today make that advice look exceptionally permissive, since the diet advocated in the books allows for about 30 slow acting carbs per day (mostly in the form of vegetables).

Low carb eating has suddenly become all the rage in the U.S., not even taking the diabetes community into consideration. The first low carb diet I remember being widely publicized was the Adkins diet. Now Paleo and Keto diets are on the upsurge. Chances are you know at least one person who follows each of these diets.

However, the true grandfather of low carb eating as it relates to diabetes is Dr. Richard Bernstein. Dr. Bernstein developed a low carbohydrate diet to improve own diabetes health in 1970 (nearly 50 years ago now) and has since been doing everything he can to spread the word and help others achieve normal blood glucose control with the help of diet. I purchased the 4th edition of his  bestselling tome The Diabetes Solution, which was published in 2011. As far as I can tell, this is the latest edition as of now. In order to cover all the bases I also purchased The Diabetes Diet, which was published in 2005.

When Kittygirl was first diagnosed I settled myself firmly in the "eat whatever you want as long as you take insulin for it" camp and determined that I never needed to read these books because I didn't believe a low carb diet was necessary and I was annoyed by anyone who even brought up the subject.

However, as time has gone on, I've realized that having some low carb options in my diabetes toolbox is exceptionally useful. I've also come to the realization that eating low carb really is the best solution for some diabetics, especially for adults with type 2 who want to avoid stressing their beta cells to the point that they need to start taking insulin.

Dr. Bernstein begins both of his books by sharing his story. He was diagnosed with diabetes in 1946 at the age of 12. After 20 years of following the recommended high carb low fat diet, he was in his early 30's and suffering from serious complications of diabetes. As a father of young children, he decided he needed to figure out if there was something he could do to improve his health and live to see his children grow up.

He purchased the first available blood glucose meter, which was actually intended only for clinical use at the time (he was able to get a workaround by having his wife, a physician, order it for him). He began regularly testing his blood sugar and a arrived at a diet that enabled him to take only small doses of insulin and keep his blood sugar close to a nondiabetic target level (mid 80's) most of the time.  He published a paper about his findings, which was resoundingly ignored.

At the time he developed the diet Dr. Bernstein was an engineer, not a doctor. Based both on my experience with Mr. Engineer and on passages from the book, I think his engineering training contributed a lot to his ability to systematically test and develop the diet. However, since the medical community was ignoring him he decided "if you can't beat them, join them" and went to medical school in his 40's. He then opened a private diabetes practice in New York.

Dr. Bernstein's diet is strictly regimented, indicating a very specific number of carbohydrates and amount of protein per meal. As a rule, he advocates against snacks, though there a few foods he allows as an occasional snack because they appear to have no effect on blood sugar.

It's tempting to look at Dr. Bernstein a a killjoy. However, now that I have read his books and know his story and the stories of some of the people with diabetes he has helped, I understand that he's really a pretty amazing person who wants all people with diabetes to live their best lives possible.

As of the release of the 4th edition of The Diabetes Solution in 2011, all of Dr. Bernstein's diabetes complications had been reversed, even some he thought were irreversible. His blood work results were generally not just those of a nondiabetic, but those of an extremely healthy elite athlete without diabetes. He has worked with many patients who had lost hope that they could ever have normal blood sugars. His office has treated both type 1 and type 2 diabetics, as well as patients who are obese and have begun to experience insulin resistance but are not officially diabetic. Though he is now in his 80's, Dr. Bernstein still offers regular free video seminars to people who want to understand his methods.

If what you're looking for is a deep dive into what causes abnormal blood sugars in diabetes, what effect they can have on your health, and exactly what you can do about it, The Diabetes Solution is the book for you. It's a huge tome and full of detail. It contains a lot of technical terms and was difficult for me to get through at times, but it could ultimately be very worthwhile for the right reader.

What if you want an introduction to Dr. Bernstein's methodology but aren't ready to dive into a huge, technical book? Then I recommend starting with The Diabetes Diet. This books is aimed at a general audience as opposed to the diabetes community in particular. In this book, Dr. Bernstein advocates his diet as the only solution for people with diabetes and the best diet for optimal health for everyone else.

The first part of the book is basically a summary of The Diabetes Solution in simpler terms, including references to that book for readers who want more detailed info. The second part is a series of recipes, most of which were developed by a professional chef whose son has type 1 diabetes. The Diabetes Solution also contains a recipe section, but it is not as expansive as the one in The Diabetes Diet.

Ultimately, while I'm glad these books exist and I appreciate the fact that Dr. Bernstein and his diet have helped countless diabetics, I don't accept Dr. Bernstein's solution as the only solution out there that can give a diabetic normal blood sugars. Once upon a time that was true, but, thanks to CGM and new types of insulin, it's possible to sugar surf your way to a nearly flat blood glucose graph. As more and more closed loop systems come to market, it will become possible even for those who don't want to sugar surf or don't understand it to keep their blood glucose in range the large majority of the time.

If you feel like the tools and options offered to you as an adult diabetic or the parent of a diabetic aren't cutting it, and  you're willing to do anything necessary to achieve normal blood sugars for yourself or your child, I highly recommend getting ahold of one or both of these books. Despite popular wisdom that "kids need carbs to grow," there are plenty of children thriving on a low carb diet. I wouldn't recommend putting just your child with diabetes on this diet, but, if the whole family is willing to make the changes, it could be a positive move for the health not only of your child but of your whole family.

Though I don't foresee our family ever embracing the Bernstein diet, I'm glad it's out there as an option. I also really appreciate that, unlike many of the recent low carb diet crazes (keto slimfast shakes anyone?) it offers guidelines in which to eat any of a huge variety of foods and does not market its own packaged foods. I actually tried a couple of the recipes myself and they're quite tasty. The "easy breakfast omelet" in particular may even become a staple of mine. However, I know my kid and I know that trying to drastically switch her diet, even if the whole family switched, would cause nothing but conflict. She already eats a different meal from the rest of the family at least 60% of the time, and, yes, I've tried all the picky eater tips out there with no success.

In Which I Review a Book with Valuable Advice That I Sometimes Halfway Follow

Disclaimer: I purchased this book with my own funds and have not in any fashion been reimbursed for this review. All opinions are my own.

Because Mr. Engineer and I are consummate researchers, we scoured Amazon for diabetes books after Kittygirl was diagnosed. I've already reviewed two of the gems we found that had a huge effect on how we've chosen to manage Kittygirl's condition. Today I'll review a third, which is well written and contains a lot of good advice, most of which we don't really follow, for one reason or another.

Adam Brown was diagnosed with type 1 diabetes as a teenager. He was told that he didn't need to change anything about his diet as long as he took insulin for everything he ate, and he continued his high carb eating lifestyle into young adulthood.

This lifestyle caused him to have huge blood sugar swings, from lows of 45 all the way up to highs in the 300's. Though he didn't like this, he doesn't blame his mother or the medical practitioners who treated him back in 2001. He views them as all being victims of a lack of knowledge.

In 2010 three things changed in Adam's life, which eventually compelled him to write his book Bright Spots and Landmines: The Diabetes Guide I Wish Someone Had Handed Me. First, he learned about nutrition and moderating carbs to reduce blood sugar swings. Second, he became involve in the diabetes community, including writing a column for Diatribe, which published his book. Third, he began using a CGM which opened a window into how everything in his life affected his blood sugar. The final result was his book, which was released in 2017.

Adam does not have a medical degree, diabetes related or otherwise, and does not write as if he does. He speaks as a person living with diabetes speaking to other people living with diabetes. His book is aimed at everyone living with diabetes, not just those with type 1 or who are otherwise insulin dependent. In fact, though I don't have diabetes myself, I found some of his advice actionable in my own life as I strive to eat healthier, be more active, and lose weight.

The book begins with an introduction in which Adam shares his story and the methodology behind his book, continues with four sections (on food, mindset, exercise, and sleep), and ends with a section tying it all together.

In each section Adam shares his diabetes bright spots (that is, things he has learned to do right and wants to replicate as often as possible) and landmines (that is, mistakes that push his blood sugar out of range or otherwise make his life difficult). He includes specific details. According to the book, each bright spot or landmine must be "Specific and Actionable", "Realistic and Sustainable", and "In My Control and Attainable."

In addition to specific examples of bright spots and landmines from his personal experience, Adam ends each chapter with a series of questions for readers to ask themselves. The purpose of these questions is to help readers find their own bright spots and landmines.

Though Adam advocates pretty low carb eating (no more than 30 carbs at one sitting), he doesn't position himself as the low carb police as some in the diabetes community do, and he doesn't advocate a particular diet. What he does do is give specific examples of things he eats which raise his blood sugar slowly and not very high as well as suggestions of small changes readers can make to eat in a way that will keep their blood sugar in range and make them feel healthier and happier. He even shares his CGM graphs after eating meals and snacks he suggests.

The section on exercise is pretty straightforward. It's not secret that exercise lowers insulin resistance and that sometimes exercise alone is enough to start your blood sugar in a downward direction. Again in this chapter, Adam gives tips about how to stay active despite a busy lifestyle. One of his favorite tips of mine was to adopt a dog, which will compel you to take it for walks and thus stay active. Somehow, even that wasn't enough for me to convince Mr. Engineer to get a dog, however :).

The sections on mindset and sleep are the most groundbreaking.  As I've discovered even as a diabetes parent, having the right mindset is a big part of the battle when it comes to living well with diabetes. We need to remember that blood sugar values are data to work with, not "good" or "bad", and we need to focus on how our choices affect those around us as well as reaching out to our community (in the diabetes world and out of it) for support. However, none of these things are normally covered with newly diagnosed diabetics or the parents of newly diagnosed children.

The section of sleep cities studies that at least 7 hours of sleep every night leads to lower average blood sugar. It gives advice on things such as what to eat for dinner and when to eat it to best avoid overnight high and lows. It also advises the best way to treat overnight lows to avoid overeating, which is a common problem especially among adults with diabetes living alone. It even addresses the fear of overnight lows, and how to address them without overeating before bed and causing overnight highs.

Ultimately, I found this book to be well-written and a quick and easy but not truly light read. Adam's advice has helped us with Kittygirl in a few ways. We make more conscious choices in what we feed her and have moderated her carbohydrate consumption (though not to the point recommended in the book). We do our best to give her lots of opportunity to be active and try to our best to allow her enough sleep at night. Attitude is still a growth area for us. All too often I still refer to out of range blood sugar as bad.  However, I'm working on it and have improved quite a bit since the beginning.

However, we haven't fully applied all of Adam's suggestions. This is partly because of Kittygirl's picky and stubborn eating habits. We manage to keep her meals under 30 carbs sometimes, but she's not willing to eat meat or cheese, berries, and peas for every meal, quite understandably. Sometimes it's simply not possible to follow Adam's advice, particularly regarding low carb eating, with our particular kid and end up with a happy kid who doesn't hate her parents or diabetes.

Even if you ultimately don't follow all of the advice in this book, I still recommend checking it out. Just following the book's suggestions here and there and looking for your own bright spots and landmines in the four areas could make a big difference in your or your child's diabetes management.