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Question: My daughter was diagnosed with diabetes at the age of 2. She is now 7. I have read Dr. Bernstein's book
Dr. Bernstein's Diabetes Solution (Boston, Little, Brown & Company, 1997) several times, and would like to put my daughter on the program. What do you think about it? I don't remember you ever talking about it in
Diabetes Interview.
Thanks for all your excellent work!
Irene Bozarth, Internet
Answer:
If every newly diagnosed child with diabetes were put on our program at the time of diagnosis, we would rarely encounter the horror stories that we hear from nearly every parent. These include the roller coaster blood sugars with frequent and severe hypos, the need for snacks, the fear of delayed meals, personality changes and growth retardation. Furthermore, we find that the "honeymoon period" can be prolonged indefinitely if blood sugars remain within the normal range (about 90 mg/dl). Prolongation of the honeymoon period not only makes diabetes control much easier, but also preserves the pancreatic beta cells.
Side Note:
When we have adequate technology, beta cells will be removed and replicated. Injection of a few million replicated beta cells in the portal vein should be able to cure a patient's diabetes without causing immune rejection of the cellular material.
When treating children, it is important to scale the effects of insulin and food upon blood sugar inversely with body weight. While one unit of Humalog might lower the blood sugar of a 150-pound individual 60 mg/dl, the same amount would lower a 30-pound child's blood sugar by 300 mg/dl. Similarly, one gram of carbohydrate typically would rasie the 150-pounder by 5 mg/dl, but would raise the 30 pounder by 25 mg/dl. The effects of insulin and carbohydrates will, of course, be distorted by any insulin the child is making if he or she is in the honeymoon period. When we are able to prolong the honeymoon period, the relatively small requirements for injected insulin are prolonged accordingly. Obviously, it is essential to use diluted insulin for small children. For a 15-pound baby, I might dilute insulin with one part and insulin and 10 parts dilutent. Diluting fluids and sterile empty vials are available at no charge from all insulin manufacturers.
By using truly physiologic (as opposed to the usual industrial) doses of insulin and very few dietary carbohydrates, we are able to avoid the unpredictability and unfortunate blood sugar effects that are so common.
Richard Bernstein, M.D., F.A.C.N., F.A.C.E.
New York Diabetes Center
Mamaroneck, New York
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