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Endgames Case Review

A patient request for some “deprescribing”

BMJ 2015; 351 doi: (Published 03 August 2015) Cite this as: BMJ 2015;351:h4023

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Re: A patient request for some “deprescribing”

My son was diagnosed with type one diabetes 2 years ago. Like almost all families, we were sent home with a diet plan consisting of 40 to 60 g CHO per meal plus 15g snacks. Watching his blood glucose fluctuate wildly after a near death from DKA was parent torture to the first degree. This torture is forever captured by the top subplot in the attached figure. Not knowing anything about nutrition or diabetes management we were still lucky enough to find Dr. Bernstein's 'Diabetes Solution'. As a scientist, I had been busy trying to model the effect of dosed insulin and CHO on my son's blood glucose levels and so when I read Dr. Bernstein's 'Law of Small Numbers', which details why it is impossible to control blood glucose on the ADA, high carb diet, it was a real eureka moment. We began to follow Dr. Bernstein's prescription at once, middle subplot, and finally got the knack of it after some weeks (bottom plot) and indeed normalized his blood glucose. My son has been following a low carb high protein diet for two years now. His A1c's are 5.0% or lower. His growth is on track. No hypoglycemia, no hyperglycemia, no DKA, no threat of complications. Hope is restored. He is the quarterback of our state champ youth football team. We will never go back to eating carbohydrate-glucose and the rollercoaster blood sugars. Never. Following our success, I wanted to give back and teach others - I teamed with Dr. Bernstein and now produce 'Diabetes University' on YouTube - a free set of video lectures by Dr. Bernstein which discuss all aspects of diabetes. I also participate in a FB group called 'TYPEONEGRIT' - here are 1000+ folks age 1 to 81 all following a low carb approach, all with normal blood sugars, all thriving.

Competing interests: No competing interests

01 September 2015
Richard D. Dikeman
Honolulu HI 96825