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Book Reviews

Dr. Bernstein’s Big Book

If you follow a very-low carb diet to manage your diabetes, you have no better starting point than the big book by Dr. Richard K. Bernstein. Even if you have been on a very low-carb diet for years, as I have, this book is a basic guide to refer to again and again.

Until a few days ago I had only four of his books. Three of them, Diabetes Type II, The Diabetes Diet, and Beating Diabetes, are important. But the fourth one, Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars, is essential. So essential, in fact, that I keep and have studied the first, second, and third editions of this book.

But the first edition came out in 1997, the second edition appeared in 2003, and the third in 2007. Since management of diabetes changes so fast, that’s long ago.

Now, the fourth edition, newly revised and updated, is out. I asked Dr. Bernstein if he had a summary of the differences between this and the previous edition that could guide me in writing this review.

The fourth edition has “hundreds of additions and changes, too numerous to relate,” he replied. At least one-third of the text is changed.

But some of the updates cover new drugs for treating Type 2 diabetes, including what works and how to use them. He tells how we can curb our carb cravings and the resultant weight gain by using new amylin analogues.

The book considers the pros and cons of inhaled insulin, insulin pumps, and continuous blood sugar monitors as well as how to make sense out of the many new insulin analogues and insulin mixtures, with special attention to a problem that many people who have hypoglycemic unawareness have, the fact that we no longer can get any long-lasting human insulins.

He also wisely debunks the exaggerated claims for new diabetes products. At the same time he highlights those of value.

The fourth edition is also somewhat bigger, 535 pages, compared with 520 pages in the previous edition. This big book regularly retails for $29.95. But Steve Freed, the owner of Diabetes in Control, tells me that you can buy it for $24.95 at diabetes911.net.

Dr. Bernstein is one of my heros, so much so that I recently nominated him for an award. Here is some of what I wrote in that application:

Richard K. Bernstein, M.D., is a physician and creator of a treatment that has made normal blood glucose control possible for people with diabetes.

In 1946, at age 12, he developed type 1 diabetes. For more than 20 years he followed his doctor’s standard recommendations for people with diabetes, but he began to suffer complications, including kidney disease.

Then, in 1969, when he was an engineer, he procured the first blood glucose meter, intended for use by hospital emergency departments. He conceived the idea that patients should measure their own blood glucose. He soon realized that his levels fluctuated wildly. Experimenting with his diet, he began to control his blood glucose by severely restricting the carbohydrates he ate. He also invented a new way of using injected insulin that mimicked the normal pancreas—now called “basal/bolus dosing.”

He believed that this technique could be used to assist others with diabetes. But, as a layperson he had difficulty gaining attention of physicians to change the standard treatment and could not get his ideas published.

So, when he was 45 years old he went to medical school, hoping that an M.D. degree would enable him to get published. In 1983, he opened his medical practice as a diabetologist.

Now, at age 77 he still has an active medical practice. He has written nine books and more than 100 articles about diabetes and has lectured at many professional meetings. He offers a free monthly webcast advising medical professionals and people with diabetes around the world.

Since the discovery of insulin in 1922, no one in the world has helped more people to manage their diabetes to achieve a long, healthy life.

This article is based on an earlier version of my article published by HealthCentral.

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  • David Mendosa at


    You must be thinking of someone else. Dr. Bernstein has long recommended about 42g of carbohydrate per day — 6g for breakfast, and 12 each for lunch, dinner, and a snack separated by a few hours from meals.


  • Joe at

    Isn’t he the guy who advocates that diabetics must consume 25g of carbs or less a day. That’s way less than any other low carb diet I’ve ever seen (most say 50-100g per day).

  • Steve Parker, M.D. at

    Dr. B is a national treasure. Whatever the book costs, it contains thousands of dollars’ worth of medical advice. That’s a bargain.