by Rick Mendosa
Telephone Interview With Richard K. Bernstein, M.D.
October 7, 1999
Dr. Bernstein begins: Charlie Suther is a nice guy. Maybe 30 years after he started working with diabetes he developed type 2 diabetes. I’ve been working on him for years to try my new patent for weight reduction and treating carbohydrate craving.
Many times [self-testing of blood glucose] has been called the most important thing since the discovery of insulin.
I went to medical school because I couldn’t get published.
Self-monitoring was especially feared by the ADA. My doctor was the president of the ADA.
Who was he? Max Ellenberg (sp). I can mention his name because he’s now deceased. He was very much opposed to self-monitoring. Most of the people connected to the ADA were even viciously opposed. Charlie may not have told you that, but the top people threatened Charlie when he started circulating the self… I published an article, self-published because no one would publish it, on how to normalize blood sugars in type 1 diabetes, and he pedaled the pavement carrying this article. I made a couple of hundred copies. They had to be offset, because we didn’t have the kind of copy machines that we have now. We had the thermofax thing. We couldn’t get nice copies. He took it around to all the major universities and diabetes investigators and the ADA heard that he was doing that and threatened that if he continued to push self-monitoring, no, if they were to sell a meter to patients that they would formally recommend Lilly’s TesTape over the Ames system for testing urine. They had been neutral in the battle between the Ames system and Lilly’s TesTape system, but Charlie was told, and you can confirm this with him, that if they were to try to sell the meter to patients, the ADA would recommend the Lilly system over the Ames.
The ADA fought this tooth and nail until they caved in slightly in 1986, I believe it was October. There was a joint meeting of the ADA and AADE, that is representatives of the ADA and AADE and a few other organizations, and by this time the demand from the patients was so great that the ADA caved in and said that they would find self-monitoring as an acceptable mode of treatment for those who take insulin, just those who take insulin, which automatically ruled out 90% of diabetics, and that was in 1986, 17 years after they first knew about it.
When did you get your first meter? I ordered it in 1969, in October or November. And I received it, I believe, in January 1970.
And that was an A.R.M.? Yes, and I have it right up here in my office. I have a museum of all the old meters. That had a built-in battery. And when the reflectance meter came out and I started using it for people…two research studies, one at Rockefeller University and one at the downstate division of SUNY, the State University of New York. The reflectance meter was no longer available, and we no longer had a portable meter. So I took battery packs from two 9-volt Radio Shack rechargeable batteries. They needed something like 15 volts, but if you put the two 9-volt meters in series you got 15 volts. And as the patients would be recharging, they had two sets. One would be in the meter and the other would be recharging at home. And I still have one of these little battery packs.
The problem for patients to get one of the early meters is that they had to have a prescription, and you were in the fortunate position that you have an M.D. wife. But which company had the first meter available on a non-prescription basis, and when was that? Okay. I have it right here. It’s called the Glucochek. No one in this country wanted me around with this heresy. So I got Zvi Laron in Israel, who still has an annual juvenile diabetes conference. And I sent him this article that I couldn’t get published. And he invited me to come and speak at his conference in Israel. And that was around 75 or 76. He had a satellite conference after the main conference for the European Association for the Study of, I think, Pediatric Endocrinology or it may have been Diabetes. I gave a presentation at his main conference and got the Ames people from Europe interested in stocking the meter and making it available to patients. They didn’t even have a meter at their booth. They were just selling urine testing. The next conference in Israel a year later they had these meters on display for use by patients. But at the first conference, the small one, the satellite conference, there were some people from England who were very interested in this concept. And they actually got a parent of a diabetic to fund the development by an electronics company of a portable meter, not a big one like the reflectance meter, but a real pocket sized portable meter, and it came out. It was called the Glucochek. That was probably in 1976, maybe 1977. It had one problem. The timer was inaccurate. It had a built-it timer and it was grossly inaccurate. And I still have one here, and here is my calibration curve on the back of it. That was probably 76 or 77. So in England these things were available for patients. The Ames meter was available in England and throughout Europe and the Near East, because of their sales manager, whom I introduced to it. Now, did they do publicity for this? Probably not. But their salesmen were pitching it to the doctors to make available to patients.
When was it first made available in the United States on a non-prescription basis? Probably, I believe they started making smaller meters when I was in medical school. The first one I have here, the Ames Dextrometer came out when I was in medical school. That was probably in 1979. But a prior one, the Ames Glucometer, was available in England at the same time as the Dextrometer was available here. The Glucometer was a superior meter. They did separate consumer research. And you know how these big companies always find out nonsense when they do these consumer research things. They don’t ask the right questions. And the Glucometer was developed for use in England because the consumer research was different there than here. And it was a much superior instrument. It was available from Ames in England, deliberately made for consumers around 79, maybe 78, and it didn’t became available here until years later, when the found the Dextrometer was a bomb.
Why does the conversation between Dr. Miller in Michigan and Ted Doan considered by several people as the real breakthrough in meters? I would think that it was the breakthrough in bringing LifeScan into the picture. That is probably what it was. LifeScan didn’t come out with a meter until I started in practice. That was around ’83.
And around that time the Accu-chek series first came out from Boehringer. One of them was superior to the Ames products. The LifeScan products were always mediocre in terms of accuracy. And they still are, but don’t quote me.
The Elite is the best one, the most accurate on the market. The Elite has been the best since the first Elite came out. Before that it was the Ames. I was always testing meters, and their meters were not accurate. They are down the road meters. And finally the Elite was fabulous.
One of the main reasons why I started all the blood sugar measurements was all the hypoglycemia. My family was mad at me. I made them miserable, terrified.
My whole reason [for going to medical school] was because I couldn’t get published. I tried desperately to get the substance of my first book. I got it boiled down to 10 typewritten pages and no one was interested.