Dr. Richard K. Bernstein - 'Practical Tips to manage Type 1 Diabetes'

Step-by-Step Tutorial: Managing Type 1 Diabetes - Practical Tips

1. Understanding Target Blood Sugars for Type 1 Diabetics:

   • The American Diabetes Association recommends keeping blood sugars between 70-180 mg/dL, but normal blood sugar for adults is around 83 mg/dL.
   • For kids, blood sugars should be 65-75 mg/dL based on non-diabetic children's levels.
   • Aim to maintain normal blood sugar levels to prevent long-term complications.

2. Recognizing the Toxicity of Glucose to Beta Cells:

   • High blood sugars recommended by ADA can lead to long-term complications as glucose is toxic to beta cells.
   • Advocating for normal blood sugars and preserving beta cells is crucial for managing diabetes effectively.

3. Prolonging the Honeymoon Period:

   • By maintaining normal blood sugars, you can extend the honeymoon period where beta cells still produce insulin.

4. Understanding Long-Term Complications of Diabetes:

   • Complications are not random but related to the duration of high blood sugars over time.
   • Managing blood sugars effectively can reduce the risk of complications.

5. Managing Blood Sugars During Pregnancy:

   • Blood sugars in non-diabetic pregnant women are lower than usual, guiding diabetic women to match these levels for better control.

6. Avoiding Insulin Injections in Inappropriate Sites:

   • Do not inject long-acting insulin into thighs, as recommended by ADA, to prevent rapid insulin action.

7. Considering the Impact of Carbohydrates on Blood Sugars:

   • Carbohydrates are not the only factor affecting blood sugar levels; consider the impact of fat, protein, and bulk in meals.

8. Differentiating Weight Loss Ketosis from Diabetic Ketoacidosis:

   • Weight loss ketosis from low-carb diets is different from diabetic ketoacidosis and can be managed effectively with proper diet and insulin.

9. Recognizing the Importance of Protein in the Diet:

   • Protein is essential for various bodily functions, and depriving the body of protein for ketosis can have adverse effects on health.

10. Addressing the Dawn Phenomenon:

    • The dawn phenomenon, where blood sugars rise in the morning due to growth hormone release, can be managed by understanding the role of hormones and insulin clearance.

11. Optimizing Insulin Injection Sites:

    • Avoid injecting insulin into muscles to prevent rapid insulin absorption and unpredictable blood sugar responses.

12. Managing Gastroparesis:

    • Gastroparesis, delayed stomach emptying common in diabetes, can impact blood sugar control and requires individualized management strategies.

13. Addressing Musculoskeletal Complications of Diabetes:

    • Frozen shoulder, trigger finger, carpal tunnel syndrome, and ITB/TFL syndrome are common musculoskeletal issues in diabetes due to glycation of collagen.

14. Treating Musculoskeletal Complications:

    • Treat frozen shoulder with trigger point massage, trigger finger with enzyme injections, carpal tunnel syndrome with wrist pads, and ITB/TFL syndrome with vacuum stretching.

15. Understanding Peyronie's Disease:

    • Peyronie's disease, affecting the erect penis, may be linked to diabetes and can potentially be treated with collagenase injections.

16. Educational Resources:

    • Dr. Bernstein recommends his book 'Diabetes Solution' for comprehensive information on managing blood sugars and diabetes effectively.

By following these steps and understanding the practical tips shared by Dr. Bernstein, individuals with Type 1 Diabetes can better manage their condition, optimize blood sugar control, and reduce the risk of long-term complications.