00:03
Welcome, hi, I'm Mikki and this is Mikkipedia where I sit down and chat to doctors, professors, athletes, practitioners and experts in their fields related to health, nutrition, fitness and wellbeing and I'm delighted that you're here.

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Hey everyone, it's Mikki here, you're listening to Mikkipedia and this week on the podcast I speak to RD Dikeman, Richard Dikeman, about low carbohydrate diets for people with type 1 diabetes. I came across RD Dikeman maybe about 10 years ago with the development of a group, Type 1 Grit, which was all about how adolescents with type 1 diabetes manage their condition with

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low carbohydrate diets. And today on the podcast, we speak about how RD's life was turned upside down when his son Dave was diagnosed with type 1 diabetes in 2013, and how the discovery of Richard Bernstein's book, The Diabetes Solution, transformed the management of Dave's condition, helped improve RD's own health, and was the catalyst for RD to take on the job of making that information.

01:21
on how to adopt a low carbohydrate approach accessible to literally tens if not hundreds of thousands of people. He's responsible for setting up the Type 1 grit group which I mentioned of which there is now published data on the success of these individuals and he's also responsible for hundreds of hours of interviews with Dr. Bernstein who has himself managed his own Type 1 diabetes

01:49
for over 40 years with a low carbohydrate diet. And Dr. Bernstein was diagnosed in his 40s, early 40s I believe. And this is all in an effort to educate and inform people on another approach outside of what conventional medicine would have us believe is the only way to manage type 1 diabetes. Ardi and I also discussed common myths that circulate about low carbohydrate diets and type 1 diabetes.

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and so much more. You are going to be so glad that you tuned into this week's episode. In the show notes I have popped the paper that was published on the management of type 1 diabetes with a low carbohydrate diet of which RD Dykman is an author of. I've also popped a link to Dr Bernstein's book The Diabetes Solution and to where you can find RD on Twitter.

02:45
So, RD Dikeman is a theoretical physicist and producer of Dr. Richard Bernstein's Diabetes University, which is that series of free videos on YouTube on how best to manage diabetes. He's also co-founder of Type 1 Grit, an awesome Facebook group for folks aged between 1-81 who follow Dr. Bernstein's low-carb approach to achieving healthy, normal, non-diabetic blood sugars.

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and this is possible. So absolutely check out those resources and RD Dikeman on Twitter as he is a wealth of information. Just before we kick into the conversation I would just like to remind you that the best way to support this podcast is to hit the subscribe button on your favourite podcast listening platform. That increases the visibility of the podcast out there and amongst literally thousands of other podcasts.

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so more people get the opportunity to learn from the guests that I have on the show, like RD. So please enjoy this conversation I have with him today.

04:00
I understand. I get it. Cool. Yeah. And where are you based? I'm in Honolulu. Honolulu. Okay, cool. Cool. I wasn't sure. Where are you? I'm in Auckland, New Zealand. That's what I thought. Okay. Yeah. Yeah. Yeah. And love Honolulu, actually. Where are you in Honolulu? So Waikiki is where I originally landed back in the late 90s. But now I live on the outskirts of Honolulu, in Hawaii Kai.

04:30
Amazing. Adrian, where were you originally? Like if not Hawaii. I'm originally from Detroit and grew up there and I went to the University of Michigan and then I went to graduate school in physics at the University of Minnesota. You're a theoretical physicist. Is that what I would call you? Yeah. Yep. Yep. Yeah.

04:58
So I went to the University of Minnesota and that was a cold place. And, uh, and I got to come to Hawaii during my physics career. And like a lot of people, I really fell in love with, um, with Hawaii. Yeah. And, um, instead of, you know, going to Silicon Valley or going to wall street, like most of my friends were doing, I decided to come to Hawaii and, uh, with really no plan, but things, things,

05:28
Things worked out. So I'm still here. Yeah, evidently. And well, I must say I'm slightly envious. I love Hawaii. I've been about five or six times and just absolutely love it. It's just so, I don't know. I mean, obviously the climate, but just the feel of the place is so nice. Yeah, I love it. I still love it. Yeah. Every day I wake up happy to be here. You know, that is amazing. So, um, I do first.

05:57
I've got to say theoretical physicist sounds like mind boggling to me as to what you might do in your usual sort of everyday life. Although that probably has changed somewhat over the course of the last 10 years. Can we kick off with, I mean, I've got so many questions that I want to ask you around type one diabetes, low carbohydrate diets. I've had Andrew Kutnick on the show before, Dom Dagostino. I've had

06:24
Others who are very Eric Westman, people that you obviously will be sort of corresponding with. I just talked to Eric Wasserman yesterday. He's such a great man. Just love him. And as I was sort of preparing for our interview, RI, so obviously, you know, I'm well aware of the low carbohydrate diet for type 1 diabetes, obviously type 2 diabetes. It almost feels like a no brainer, but I feel like there's a real stigma.

06:52
or there's something about a low carb diet for type 1 diabetes where people are just a little bit more cautious would be putting it lightly and some are absolutely against it and people in the profession as well. I came across this website and it was a registered dietitian and she had diets you shouldn't do.

07:14
if you have type one diabetes and she listed a bunch of them. I know it was awful. I was so embarrassed for her because she, one of them was the Dr Bernstein's diet saying it was outdated and unsustainable despite the fact that Dr Bernstein's been on this diet for over 40 years. Like, and I felt so, I felt outraged and I just thought, gosh, this must be what RD, I'm sure you don't feel, or I, I'm not sure how you feel. I would really like to ask you, like, like these are things that you must see every single day.

07:44
That's right. Yeah. So the funny thing is that, you know, at the beginning of the diagnosis, the big mystery for me and for Dave, who's my type one son and my wife, was how we could keep Dave healthy and complication free because controlling blood sugars is what

08:12
the diabetic complications. We all know that. Yeah. And, uh, so, but that mystery was solved rather quickly that that's primarily because of the Bernstein book. The, however, the mystery that remains is the mystery that you're talking about right now, which is the weird, uh, undercurrent in the diabetes, really the type one community, not, not even so much in the type two community.

08:41
It's this weird undercurrent in the type one community. And it seems so that's that's my mystery. And I have some I have some hypotheses that I've developed about why why it remains and how to get rid of it. But yeah, it's a it's a mystery and it's a frustrating mystery because you see a lot of you you see a lot of agony and impending agony that's being foisted on

09:12
people who are voiceless and they don't have the wherewithal to do what is required as far as finding information and standing up to their somewhat authoritative care providers to help themselves or their children. And so it's this awful situation and it seems to be never ending.

09:40
It's like the never ending war or whatever. It just, it just doesn't seem to get solved. But anyway, that's a, that's a one hour conversation we can have. I know. And, and I certainly, like I, I, I, I'm sure this is going to come up numerous times and aspects of this frustration will come up throughout our conversation. Can we begin, Adi, just with your own personal story discovering

10:10
the type one diagnosis, like how that sort of came about. And then how you discovered Dr. Bernstein's book at that time. Yeah, right. Well, my son was nine and his diagnosis was not that unusual. He, he developed symptoms, what I, which I did not recognize of, of type one. And his doctor missed the diagnosis as well.

10:38
both of those things are very common because type one is rare enough that you might not have a, um, experience in your life for yourself or anybody who's had it. There are parents who know somebody like a cousin or a friend who had it and they catch it early, but we did not catch it early. And, um, so Dave, and neither did the doctor. So Dave ended up having a, uh, uh,

11:06
fairly near-death experience in ketoacidosis where he, you know, I can show you the pictures of him at diagnosis with his shirt off. And it was a real traumatic experience for everybody. Yeah. But it wasn't unusual and that happens quite frequently. And that's a whole topic to discuss really is how you can detect things early.

11:35
But the main point of our story is that when we learned what was happening when we tried to follow the standard approach to diabetes management, which is taught to everyone, this concept called carb counting, where you come up with a meal system which is...

11:57
close to 50% carbohydrate. It looks like this food pyramid, which you probably have something like that in New Zealand, some kind of government grain based system of eating that they try to, they try to foist that on, on type one diabetics and it doesn't work. And we could see that it doesn't work in the data that we were collecting. So you were monitoring, you were writing down,

12:24
the what David would be eating, Dave would be eating and then assessing how much insulin you were providing and then seeing what happened to his blood sugar. Yes. And because I'm a scientist, I thought I would be smart enough to figure out how to do what other people might not be able to do because of a lack of something.

12:52
And what I discovered was, and right about this, this is in parallel, my wife was watching over my shoulder do these experiments with Dave for the first month. What I discovered with the models that I was building, and this is back 10 years ago, what I discovered was that the process, the blood glucose that was the result of this process, was it had a,

13:21
a character to it, which you could identify it in scientific terms as stochastic, meaning that it was a random result that was occurring, meaning that you couldn't repeat it. The goal was that, oh, if we kept things consistent, we could eventually hone in on the solution. And that's when you have a system which can be optimized to a nice, I don't know if you've seen my hands, but a nice convex system.

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this was not such a thing. It was, uh, instead it would be that you would repeat things. And I recognize that as this is a system where the inherent noise, the inherent system noise drives the process beyond its limit of control. And so I was having this epiphany and meanwhile, my wife just ordered chief, she found the Bernstein book on Amazon.

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because it became sort of foolish that we were continually trying to feed meals of carbohydrate when Dave could just eat an omelet and things would be significantly better. And, you know, there was like this, when we talk earlier about why is this, it's not just like, there's a lot of reasons why this carbohydrate approach persists.

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that there's a myriad list of myths that exist in the type one world. And one of those myths, well several of them has to do with a child's need for carbohydrate. Kids need carbs for growth. They need carbs for energy. They need carbs for their brain. All those kinds of things you've had soak into your psyche over your, if you're not a food expert or even if you are a food expert.

15:20
You know, so this idea of a low carb diet for a kid on its face was something like it sounded wrong and it sounded like something, unless you had some conviction and some knowledge, you could easily be thrown off that path by someone who claimed that they were some sort of expert, just like the situation you just referred to earlier.

15:44
So obviously you guys adopted the Bernstein approach and I really want to get into the sort of what the approach is and I know there are some rules that we can probably let the listeners or share with the listeners in addition to of course I want to address the myths that are out there. But when you guys discovered this and started adopting it and then went back to Dave's diabetes management team or however that looked, what was your initial response?

16:14
We knew enough to keep it on the down low. So my interest was not in getting a stamp of approval from our doctor. And we were lucky enough to have a doctor who did not pry. We did go, this is a story. We were so freaked out by the initial diagnosis that we visited my mom in Cincinnati.

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And that's where one of the top diabetes centers is located. And we thought, well, we only want the best for Dave. Let's move from Honolulu to Cincinnati. And so he can have the greatest care. So we, we were actually visiting. So we went in for an appointment and it was an absolute disaster on every level. And they had no idea how to generate normal blood sugars. And they were very authoritative in that they wanted

17:12
to take your data from you. They wanted to know exactly what was being eaten. They wanted to know. That was an unusual experience to feel like you were under the boot of the Gestapo rather than having a doctor who was working for you. And the doctor seems to know almost nothing about the condition. So

17:37
We were actually glad to go back to our doctor who sort of, he could see Dave's blood sugar results and he could see Dave was doing well and okay, you know, let me know if you need anything. That was his point of view and he's always been like that. So lucky. Well, that is awesome. And there are doctors out there just like the one you described, like your family doctor, you know, like he can see obviously that David was thriving under this. I have to say, just as an aside, there are doctors.

18:07
that a lot of the time, because I'm a nutritionist and I often want my clients to get blood markers measured and stuff like that. And I say to them, I'm like, you know, just say that you'll pay because of course they've because we've already talked about the fact that it might cost them a little bit of money. But even when my clients suggest, you know, say I'm working with a nutritionist and we'd like to get these blood markers done, I'm happy to pay, the doctors refuse like it's their right to refuse. And I, yeah. And I understand.

18:36
resourcing and things like that. But ultimately, I sort of think your doctor, exactly what you said, your doctor is supposed to work for you. They're not supposed to be there giving you the tick of approval or disapproval or... But I think people are, a lot of people I talked to are unaware of that. I don't know. Yeah. It's very, you know, it's very scary to go up against authority, right? So. Yeah.

19:02
Adi, with regards to one of those first things that you said about Dave was one of the myths of children needing glucose and needing carbohydrate for energy, their growth and development needs it. Like, was it just a, like, obviously, I imagine that you both probably would have thought that too. And then you discovered Dr. Bernstein's book and then you started researching a little bit more for yourself. Is that right?

19:29
That's exactly right. So we, we, um, and we started right away implementing his procedure. And I think my biggest regret about the whole process was that, uh, well you could say it didn't take long, right? It did take us. We looked, we looked at the Amazon book order date. It took a month, but, um, my biggest regret, it's not really a regret, but my biggest wish would be that we would have been, see the book,

19:57
If you look at the book, it's a big reference book. It's for everything that he knows about diabetes type one and type two. I needed someone to sit with me for an hour and say, here's what you need to do with Dave. You know, here's how you use insulin. And just in a day, we could have had all the information that we needed. So it took a while for me to distill all that information from his book.

20:26
a few months and I wish it wasn't that hard, but there is a pretty steep learning curve to the whole thing. It is what it is, I guess. Of course, I want to talk about the resources and stuff that you've co-created with Dr. Bernstein to help people digest that information and make it super easy, as simple as possible, I suppose, to be able to implement that.

20:55
With regards to what you say about the growth and development, I've heard that too, and people often refer to the early ketogenic trials of children with seizures as proof that children need carbohydrate to grow because when those children were on classical ketogenic diets they had a stunted growth pattern, which is quite a bit different to actually the Bernstein approach and people just get confused about...

21:22
the low carb recommendation for someone with type 1 diabetes and classical keto, which is another therapeutic approach, but it's quite different, isn't it? They're very different. And if you're doing that classic keto approach, which I don't even know the extent of, but we'll just stick to type 1. That's my wheelhouse. In that classical keto, we're concerned with driving ketones higher.

21:49
In the Bernstein aspect, the emphasis is not on ketones at all. It's on normal blood glucose and it's on protein foods. So, the diet is a protein emphasis diet. It's not a low-carb, high-fat diet per se. It's not that the diet isn't high fat. It's that that acronym, LCHF, doesn't properly translate the emphasis that he puts on protein nutrition.

22:19
And if you're a parent and you want your child to grow and your child's type one, the two things that you actually want are protein nutrition and normal blood glucose. So we know, you know, carbohydrate has nothing to do with it except for helping out with the caloric need. But you can reach your caloric goals.

22:46
on a very low carbohydrate diet for a kid. And we know that by inspection of the meal plans, but we also know that by looking at the kids who are doing this now, they're all developing beautifully and reaching their maximum potential. So it's protein and normal blood glucose, not carbohydrate and high blood sugars that are going to foster proper, you

23:16
growth and development. How does that disruption in blood sugar levels that come when you are unable to match your carbohydrate with insulin, how does that impact on growth? Because I don't think people are so aware of how detrimental that can be. Okay. So in the standard approach, this kind of goes to why low carb diets are essential and why they work in the type one world.

23:46
it doesn't necessarily have to do with any kind of nutritional argument. You see that the point is that you, well, if you remember what I said earlier, that this standard approach that we tried generated a stochastic result, meaning that the blood sugars were not predictable. And you can see that on anybody that's following it, the standard approach, you can see that on their blood glucose traces.

24:16
from one day to the next, there are just wild oscillations. If you overlaid, let's say, 14 24-hour periods of someone who's eating a standard high carb diet, the graphs would be all over the place. And we can pull one of those up if you need to see it, because I have them. That's definitely different than the kinds of blood glucose that you've talked about, Andrew Kuitnick or Dave or anyone that's following a low carb approach. And what's happening is that...

24:44
When you're trying to cover rapid acting carbohydrate with a fast acting insulin, it's impossible to get a perfect match of those two things. There's enough system noise in play between your digestive system, how well the insulin's absorbed, how well you counted the meal, et cetera, et cetera. There's enough noise in play that those things will never match up and the shapes of the curves will never match up.

25:13
And so that's enough noise to drive your system into a random result. But when you're doing a low carb diet and you're in the bulk of your insulin that you're using is actually to cover the protein foods. Most endocrinologists and dietitians don't even realize that you need protein. I need insulin to cover protein, but protein is so slowly digested that

25:43
when you use an intermediate acting insulin, or if you use a pump that has a delayed bolus setting, then even if you're off a little bit with that same system noise, you get blood sugars which are slowly varying and can easily be corrected before they get out of range. And by range, I mean, you know, 70, or you guys are like, let's say four to six millimoles, or,

26:12
our range 70 to 100 milligrams per deciliter. Yeah. Yeah. Yeah. So that's the thing. It's the physics of injected insulin that favor a low carb diet. And that's a totally different thing than why low carb diets work so well with type two diabetes. Yeah. Yeah. Yeah, completely. And I remember Andrew talked about just how complex...

26:39
matching insulin and carbohydrate was because all of the factors that impact on how we utilize carbohydrate because you might go for a walk after a meal. You might not have slept properly. You might feel stressed, like all of these factors. I have to say, when I was reading on that dietician's page that it was an outdated approach and the reason she said that was because insulin therapies have moved on since Dr. Bernstein wrote a book.

27:09
Physiology doesn't move on though. This is the main problem, is that it's really similar to someone sitting down at a slot machine and thinking that if they move their body this way or they pull it fast or slow, that somehow they can conjure out the result they want. Then they get a good result every once in a while. They think, okay, I'm on to something. Yes.

27:38
It but they're not. It's just that you get lucky. You can see that in the in the social media groups. People will say, I ate pasta and boom, my blood sugar was great because I used a dual wave bolus. And it's it's like you just got triple sevens on your slot machine. But next time you pull it, you're going to lose. And over time, your losses are going to outnumber your wins and you're going to have consequences to that kind of thinking. But.

28:08
just like with gambling, there's this psychological payoff. So there is with eating pasta and all the cookies and cakes and all those foods that excite probably the same brain structures that gambling lights do. So it's a pretty good analogy on multiple levels. It really is. Adi, do you know when I think it like,

28:36
I imagine that is the case. So when I touch base with you about a podcast, what I saw, which really just remind, I'm like, oh, I saw a tweet of yours and I'm like, that's right. I really want to chat to Adi about this because you said type one, people with type one diabetes deserve to have normal blood sugar levels. You use language, which almost made me think, and it reminded me that there are doctors that I've seen who do not like.

29:06
people with type 1 diabetes to have normal blood sugar levels because, you know, what is the, what is the block there? Like what is it about the blood sugar management or what they see as management, which is actually high blood sugar. Why is that the recommendation? Well,

29:24
If you ask Bernstein this question, which he's a good guy to ask because he was the originator of this idea. And he spent his whole life trying to get it accepted into the professional associations in the literature and so on. So he's been on the front lines alone most of his life trying to fight for people with diabetes. And he will tell you that the doctors are not.

29:53
willing to stray from any legal entanglements because professional associates and guidelines are what they are. And they allow for lots of carbohydrate, lots of variability, very high blood sugars. And if the doctor says, no, I want you to have normal blood sugars, then if they have any hypoglycemia.

30:22
the doctor can get sued. So that's kind of like that's one of the main stories. The other story is that using insulin is not easy and this method, this low-carb method is understood by nobody. That is the most astonishing thing to me that we found this book in one month and yet there are thousands of physicians who are

30:53
who are so incurious that they've never contemplated even once that there's a potential that their patients could be running normal glycemia and have not stumbled across the book. And as a physicist, we are constantly looking on the vast shores of the universe for tiny little seashells.

31:21
that is our jobs and everybody is fighting for that tiny little seashell and to get there first. Whereas with this, um, endocrinology problem, it seems like no one is curious. You know, I, I, I w we've been very vocal and very, um, uh, we can talk about the advocacy, but I'm a very loud advocate for type one diabetes. I have never been approached by

31:49
a single endocrinologist. And I'm a co-author of a paper that got covered in the New York Times. I've never been approached by an endocrinologist. You would think someone would call and go, hey, I read about Dave's story. How do you cover protein with insulin? Or aren't you worried about how does Dave or, you know, there's lots of questions that would come to your mind if you had been sending all your patients down the tubes for decades.

32:19
but it's never happened. And Bernstein doesn't get any calls either, by the way. It's not like his phone is ringing off the hook. You know, teach me your method. My patients are doing so poorly. And yet every time we teach somebody to do this method in our social media groups, within a couple of weeks, the report back from the endocrinologist is, Oh, you're the best patient we have in our group now. And

32:46
you should run higher blood sugars anyway. So they acknowledge that the person's doing great, but then they tell the person that they should run higher blood sugars. They don't, you don't have to run normal blood sugars. So we always, we were always going to loop back to these crazy stories, right? But the main idea is that there is a solution. There is a way out of this nightmare. And I, I sometimes dare to

33:13
you know, type one is referred to as a disease and I suppose it qualifies for a disease. But to us, I find like the word condition is probably a better descriptor that Dave has this type one condition. I think there's an idea there that that this low carb diet turns this disease into a condition because if we, if we could find a way to help all type ones get access to this,

33:43
information, then they could follow this procedure and have the opportunity to run normal blood sugars and avoid the complications. And then we would, then all we would have left is what a pain in the ass managing this condition is. And then we could start working on that. Yeah, a hundred percent. And I think, and I feel like it's almost at a point or it has been at the point that

34:12
poor health outcomes are this inevitable outcome of type 1 diabetes. And I wonder whether parents and children are sort of, they have that information from the get go. As I understand it, Dave was actually aware, like he was educated in the potential pitfalls or the outcomes, the negative outcomes of type 1 diabetes and understands really well

34:41
you know, as a particular, obviously he's an adult, you know, he's an adult now, like 20 or is he 20, 19, 20? Let me think. He's going to be 20. Yeah. That's right. I, I, I followed you back, I think in 2011 or something like that. So I remember him as a, as a, like a little kid, but like even then though, I, as I understand that he understood the dangers of, of hyperglycemia for him, didn't he? Yeah. He, he,

35:11
he understands that there are consequences. And that's kind of the first step in developing some sense of accountability is understanding that there's some consequences. So. Do you feel that because I chat to parents and parents don't want their children to feel restricted, they don't want their children to feel left out and I feel like the negative outcomes are almost

35:41
brushed under the table or not as acknowledged. You know, what is that? They're never discussed. What do you think, Adi, what is it about? Because it's not through lack of love or lack of wanting the best for their children, but it's almost like that they just get they get afraid that their children are going to have this restricted lifestyle if they change their diet. So we go back to the grand mystery of why now originally.

36:09
we were shouting from the rooftops because most people didn't know. And I was very good. I was very good at shouting. And now a lot of people know because back when Dave was diagnosed and doing this, there was nobody else that we knew of. And now if you go into any group and you say, Oh, you know, there's always going to be a low carb or who will make a comment. Right. So that's a,

36:38
positive, but the question then is, well, why, why are some people still doing? Are they not aware of the consequences? I will say that the big surprise to me was not that people, well, people disregard the consequences, but you see, if you're going to raise a type one child on a low carb diet,

37:03
doing a low carb diet with all the temptations, if you're a child, is a very challenging thing to do. So if I would have raised Dave and we would have been eating cake and ice cream and bagels and, and always making Dave like an omelet while we had spaghetti and stuff like that, it would not have been the right way to run a family. So what did we have to do? We, the only option we had was to do

37:33
the same diet that Dave did. And that includes his little brother. And, and guess what? The food that we were eating before Dave was diagnosed, the high carb food is addictive. And I went through, I didn't really believe that. Of course you had heard, you had heard those things, but I had, uh, you know, I went through like a period of a couple of months that was an astonishing, uh, it's like to quit.

38:02
you know, my favorite Starbucks cookie and some of the things that I would eat, that was kind of like an astonishing experience. But the benefit was that my health, you know, dramatically improved, but that's, that's a big hurdle for most parents. Not only do they have, they have to change their own eating style. And you know how, I think if we sit back and we observe the world at large, what

38:31
this addictive processed food has done to people as far as type two diabetes and obesity, because nobody wants to be obese and no one wants to have type two diabetes, yet everybody has type two diabetes now. It's addictive foods. And so people, that is the, when I talk to people who question whether carbohydrate is a addictive component of processed foods,

39:00
The best example I can give them is that parents won't give it up even if their child is type 1. Even if they're measuring this kid's blood sugar all day long and they're aware that this is going to cause their child to go straight down the tubes, they can't give up the carbohydrate. So what chance do you have if you're just part of a normal...

39:25
family system without any type one diabetes. And you can always just say, ah, we'll just, you know, we'll just eat some cereal or something like that. It's an impossible situation. Adi, do you cover this stuff in the information that you put out there? Because this is, you know, I know this as a nutritionist, you know, it's almost never, it's not just the food. Like it's never just the food that has to be changed. Like changing that inner.

39:53
the sort of mindset that the mindset around it is like so important. Like how do you address that when, when you come up against it in your type one grit group or the forums and stuff that you're on? Well, you, you have to tell people the truth. And, um, so when I get, of course people do reach out. And, uh, that is one of the first things that I tell people. And I've observed people for 10 years doing this and I can tell you,

40:21
There is not a single example that I know of where the child is successful, but the parents both go on with the way that they were eating before, which is like the normal high carb diet that everybody eats. Now there are situations where maybe the mom will and the dad won't, and there are situations where maybe there are eight kids and the only the, the type one child and the mom will.

40:50
but one of the parents at least has to do it. But if both parents do it and the whole family does it, then you have a fighting chance. The problem again is that parents won't do it. And Bernstein alerted me to this problem too, because he's got stories of, you know, he's got stories of like heartbreaking stories where you've got like a 14 year old girl, I think he had as a patient, and the parents were both obese and they refused to give up

41:20
ice cream and chips and it just didn't work. Eventually a kid is gonna be susceptible to that sort of temptation. Yeah, yeah, of course, of course. And it's interesting, because whenever I read something like this diet is unsustainable, I just roll my eyes at the judgment call that

41:47
someone can make over someone else's sort of decision over whether or not something is sustainable or not. Like the benefits of, well one, the benefits of the diet for type 1 diabetes is, you know, as you've said, like they're just, it's overwhelmingly positive. But two, like there are so many delicious foods that might not necessarily suit...

42:11
someone in another context that are low carbohydrate, but there are very good substitutes out there that people can be included in the diet. It isn't just chicken, breast, and broccoli. It's a non-issue. Once you get over your addiction, it's a non-issue. And you don't even, so what usually happens is you get over your addiction, you fall in love with all these low carb methods, and then you get tired of that.

42:39
And then after a few years, you just eat like, like in our family, it's, it's, um, you know, Dave's gone now, but he was back over the summer and it's like, we're just eating, you know, a protein food and a salad and, and that's kind of like, uh, food is not, um, it, it doesn't have this, um, so you say, Oh, you, you, you miss out. And it's like, no,

43:09
I remember what it was like when food had a hold on me, when I would be looking into the refrigerator like a zombie for something. And now it's, it's like I don't, you, you have control over the way you eat now. So it's a much, it's of much relief that there's no more lack of control.

43:37
I would never want to go back to that. And that is a universal comment. It's not just me that says that. Yeah, no, so true. So Adi, like obviously we've talked that the Dr. Bernstein approach is a high approach to a normal blood sugar approach to diet. What are some other features of the diet for people who are unfamiliar with what even

44:00
Dr. Bernstein's diet is, are you able just to sort of briefly run through them for us? And of course, we're going to include links to all the resources and stuff. Yeah. So the food really is like, he has a, it goes by six, 12, 12. That's his breakfast, lunch and dinner. And you're allowed up to six grams carb, 12 grams carb for lunch and 12 grams carb for dinner. And

44:27
The point of that is not that you need any of that carbohydrate. The point is that he decided that you might need some vegetables in your diet. So the car, the car, the reason to eat any carbohydrate is probably some vitamins in your vegetables that you need. But again, the main thing is, you know, that you, you want to, uh, get your, your pro, every meal has to be

44:55
is a protein-based meal. And so there's some interesting benefits that come from that. So I mentioned you're able to match those kinds of meals with insulin better. And that's really the big benefit is because diabetics die early. A type 1 diabetics will die, especially if you're diagnosed as a kid, you'll die 12, 15 years early. And along the way, you're going to develop a

45:26
But there's so, but the normal blood sugars should be enough, but there's even more benefit because what we see now is because of people like the dietitian that you mentioned who said that the diet is not sustainable, those types of people are opening the door for people to accept the current standard Western diet. And what does that diet accomplish? It accomplishes

45:55
obesity and type two diabetes. And sure enough, in the type one community, we see record levels of obesity and type two diabetes. So now people have double diabetes, including in children. So my personal story along those lines is when we started advocating, of course, there was significant pushback from loud parent.

46:24
type one advocates who are in many cases paid by professional diabetes industry companies. And so you can find these people all over the place and they had kids too. And the vast majority of the kids that followed those diets, you can see now on social media and they're not fit, healthy looking people. And then with

46:53
with Dave and all these other type one grid kids, they're all lean, strong, athletic, because if you eat protein, you know, they're eating like professional athletes. The professional athletes don't eat Doritos and cookies and cake to try to be like non athletes. They eat because they want to succeed and they have goals. And that's the way that the type one low carb kids eat.

47:23
Yeah. And so, you know, I had like Dave has he he received both academic and athletic scholarships to attend universities and football and and just for just for academics. So, you know, all those people that criticized Dave heavily and criticized us heavily at the in the end,

47:52
Who was the one that followed a sustainable route? The people who now have raised kids who have weight problems and are developing, surely developing complications of diabetes or a kid who knows so well how to manage his condition that he can go away to college and do it on his own. Like what was the role of the proper role of the parent there? Was it to...

48:20
teach a kid how to manage their condition for the future? Or was it to shove their face into a bowl of processed food and get some weird short term gain at the expense of their entire metabolism? And this is again where I feel like the actual health problems associated are just

48:44
dismissed or not, not, not even not talked about. I mean, they're, they must be mentioned at some point, but they're so, um, downplayed because if parents knew more, I feel like that they might be more motivated to, um, to actually change. I'd be so, how did you go about setting up the type one grit group? Because, you know, it's one thing to read a book that some old guy writes, and it's quite another thing to set up a group, to start a YouTube channel,

49:14
information to life. And I know, of course, you've said that you, you would have liked to sit down for an hour with someone. Is it, is it all stemmed from your experience? You're like, I've just got to get this information out there. Yeah, it was just, it was just that I, we ended up calling Bernstein and saying, look, you gotta, uh, help break your stuff down a little bit on YouTube, get it out into other avenues and we'll do an ex we'll do an experiment and put these, um, you know, he was,

49:42
he was getting old at the time we started. But, um, so I felt like there was some urgency. Little did I know that this is 10 years later and he's 89 and he's still exactly the same as far as his cognitive abilities, let alone his physical abilities, still going down to the Caribbean and playing in the ocean. So he's kind of a force of nature, but I thought we needed to sort of capture all the information because I, when I started talking to him,

50:12
he would tell me things that I didn't know about in the book. And I said, why didn't you put that in the book? He said, the book is was limited to a certain number of pages or also be too big. So we said, okay, let's, let's, um, let's start getting this stuff on video. And then, then there was, you know, the grid group started because we were going, uh, to try to meet other people who were parents.

50:42
And that was like a total dead end because the parents were. They, like you said, that was it was all about how much birthday cake we could get going into the kids and without any discussion of the consequences. And so when we started talking about Dave, this this wild scene developed where people were threatening to kidnap Dave and it was this crazy situation on social media. Yeah. But anyway.

51:12
the people that I did meet that were following Bernstein were type one adults and there weren't many of them, but they were all getting the same result. You know, everyone's A1C was like 5.0% or less. And, and we started to, you know, make a little chat room and, and we would go out and we would try to spread proper information about how to manage the condition. And, um,

51:40
Every time we would open her mouth, you know, the world, you know, people do not want to have their cake taken away from them. And they, you can develop a personal narrative, which is based on helplessness. And so when you challenge that narrative that people have carefully constructed over decades, they're going to push back. And, um, so that was a surprise. I thought everyone would want to, uh, sure. I'll give up cake if I don't have to like,

52:10
die early, but that wasn't the case. And so we needed to make a special group where, you know, people had the same values for their kids and for themselves. And the grid group is a little different because it's both parents and kids. If you notice the high car groups segregate and that's because the conversations in the parent groups can be quite gruesome.

52:39
I mean, in the in the adult groups, as far as the problems that people are having, foot prop, like the classic diabetes problems, feet, eyes, and so on. So the parents tend to segregate, but the grid group was the opposite. You know, the adults were inspired by these kids who were actually getting it done. And the kids were learning from the adults that they could do it for a long period of time. And there was a real good synergy in the group because of that. So yeah.

53:09
So yeah, and now there's lots of, there's lots of low carb groups now. There's not just type one grit. So yeah, it, uh, yeah. Andrew Kutnick said he was so inspired when he discovered the group and he, and it was, it was a real, yeah, it was that real source of, um, encouragement and inspiration and gave him confidence to talk about his experience, um, with us, which I don't need to tell you that, cause I'm sure you've had that conversation with him.

53:36
So it's yeah, it's amazing what you guys have done. He's about as inspiring a person as you can meet because of his intellect. And, you know, he's a truth teller. But, you know, when I show Dave his videos and his pictures, Andrew's also built himself this incredible physique. And it's like, OK, you know, Dave, there's like diabetes.

54:04
not stopping you from attaining this kind of, you know, athletic control of your body in the future. You know, you can really do anything. So Andrew is like, he's like a superstar in the type one world in my opinion. And he understands everything, right? He's a genius. So.

54:31
Is there a difference in how you approach this if you use like an insulin pump versus a like injecting insulin? Like are there any issues or any sort of considerations there? Yeah. So in the grid group, it's kind of, I would say, I guess would be 50-50. So it comes down to what sort of gear that you want. Some people prefer gloves.

55:00
prefer mittens, you know, something like that. So I don't see, now Bernstein's big concerns with pump is that you can develop scar tissue under the skin, which is invisible, and that will degrade the consistent absorption of insulin when you inject so that you won't be able to inject your mealtime insulin and get the same result every lunch.

55:30
There are people in the grit group who do use pumps for a long period of times and claim that that is not a problem that they have. Then there are people who do say that. So that's like my caveat to Dave. If Dave chose to start using a pump, he uses injections. My, my advice to him would be like, well, after a couple of years start looking out for this phenomenon where

55:58
you know, it seems like the insulin didn't work that time. Um, that, that's about it. And, um, now the beauty of the, the Bernstein is that you can use for your bolus insulin, you use regular. So regular insulin is not only perfect for low carb meals, it's cheap and you can get it over the counter in the United States. You can go to Walmart and get like a ton of insulin for really cheap. So that's a nice benefit.

56:28
If you want to do that with a pump, what people do is they do this kind of square wave bolus or extended bolus. So you're sort of taking a bunch of these narrow insulin action peaks and sort of stacking them up and widening out the action to sort of mimic basically what regular insulin or humuline R or novaline R are doing. So that's what people do. They take multiple doses with their pump.

56:58
either manually or they use that function. And, you know. And that covers them for the day, does it? So you're not using the fast acting stuff that gives a big spike because you don't need it. But you might need to use it. Okay, I did a bad job of explaining that. Yeah, no, sorry. Yeah, yeah, yeah. Okay, so let's do both cases. Yes. Let's do Bernstein for both cases. Yes.

57:25
Dave, Dave does MDI, multiple daily injections. He gets away with one triceba dose every morning and that's it. But he used to take Levamir for his basal insulin and that was three injections a day. So usually you have to split your basal dose. Then on top of it, you have to take a Mealtime bolus insulin with low carb.

57:51
Bernstein suggests that you use regular insulin, which is an intermediate acting insulin and perfect for matching the action of protein foods. That's really like the magical thing about his approach is using an intermediate act. Okay. And then he uses fast acting insulin for any corrections that you need along the way. So Dave carries around three different types of insulin with a pump. You're just using fast acting insulin. You load up a cartridge,

58:19
with Novolog or Humalog. And then the pump is giving tiny little bits all day long, which constitute your basal injection. So there's that that's the basal. And then it'll get the big pump when you're doing your your your meal time bolus. And if you're doing if you're eating like a steak and salad, you'll notice that if you give some insulin up front, you might go low.

58:49
because it takes a long time. There's the steak and here's the insulin for the rapid acting pump. So what you want to do is you want to have a bunch of little pumps and you stack them together. And then that ends up, you know, through trial and error you learn how to cover a low carb meal that way. So that works. People get the hang of that pretty quickly too. And Dave wore a pump for a while and we got the hang of it.

59:20
It just became a little bit harder. It became for a kid. It was so easy to give him. I think you call it, let's see, you call it, um, I forget the name of a regular and news me like you call it Acu rapid or something like that. Oh yeah, yeah, yeah. Yeah. Something like that. Our peeps listening will know the ones who need to know will know. Yeah. Yep. It's not coming to my head, but there is a, there is a version. Yeah. But anyhow, that

59:49
With, with for Dave, he just eats and he takes his injection and then he, it's smooth sailing for a couple of hours and then he'll see if he's drifted a little bit, you know, I do like obviously a lot of the foods we're talking about protein and vegetables and protein, you get the hang of vegetables, you know, green veggies, very low carbohydrate. What about the sort of net versus total carbohydrate? And I asked that because, you know, I put on a CGM and

01:00:16
had a low carb protein bar that had net carbs of two grams and my blood sugar went up to 11 because of the fiber and stuff. You must see people sort of get a little bit confused around stuff like that as well. 11? Wait, you went up to 11? Yeah, yeah. Yeah, that's very high. It is very high. Yeah, it was crazy. And my normal diet stuff is like normally when I eat my normal foods, it's, you know,

01:00:42
the highest it might get to is like 7.4 or something. I don't know. It sort of hangs out on the lower side, if you like. But that, yeah. And I put it down to obviously the fiber in the protein bar that they call low carb, but it had this sort of surprising effect on my blood sugar. Like, do you see that a bit in your groups and in the people that you talk to? Yeah, so with the type one, people...

01:01:10
they, you know, the low carb is they don't trust just the carbohydrate count. They want to see the ingredients and the rule that we go by for ingredients is no grain, no starch, no sugar and no sweet fruits. And so that's the thing. Like people was post, like is this candy bar safe says low carb and people will look at it and say, I don't know about.

01:01:39
tapioca starch, right? That, that is going to spike you. So people are onto the ingredients primarily. The carb counts are, can be tricky, right? So there's a lot you'll find in the social media groups, a lot of discussion about those fringy type. And then some people will say, it didn't work for me. We tried it. It didn't work for me. You know, it does have this tapioca starch and it did hit hard. And so then, you know, then

01:02:08
then you probably should avoid it, right? See, it's not just, you went up to 11, but for a type one, like for Dave, if Dave goes up to 11, he's gonna take hours to get back down and he's gonna have to do it manually. It's not like, oh, I'll just give myself an injection and then 90 minutes, I'll be back to normal. No, no, no, no, no, no. He's gotta play this game where he gives an injection and then he watches and then in 90 minutes,

01:02:37
he's still 11 or he went up higher or now he's, he's three and crashing, right? So you don't want to be up and then down because then you have to play that game. And, um, with type one, you're, you're inevitably going to have to play that game. You know, like when I, when I first started,

01:03:02
helping people, I would get like a call from like a friend that I just made in New York, for example, and they would say, Oh, my pump broke and now my blood sugar is like 350. And I need to go to sleep and, and you're in Hawaii. So, you know, it's still early for you. Can you like, I'm going to text you in an hour to see what happened to my blood sugar. Cause I put a new pump on and can you

01:03:28
You know, if I, if you don't get a text, can you call my number? And this is like, this is the kind of life that you, you lead as a type one. It's always this 24, seven battle. Um, so imagine doing that and then losing all the time, being like this, this all day long, you know how much work is involved. And, and then, you know, we wonder why,

01:03:58
Um, you know, not with just the neurochemical stuff that's happening when you do that, but the, just the, the depression that's induced by not having any control. So, and we wonder why, why people with high A1C's are more depressed. It's because that's a grueling, it not only feels awful, not only doing damage, it's, it's grueling. Yeah. Yeah, for sure. Um, Adi, I'm mindful of your time. So I just, um, I just really.

01:04:28
want to finish up by, you know, do you have any, what's your advice for people who, who have been curious about it, but have yet to make the leap if you like. And obviously, and I'm not even just, just talking about parents of children with type one, but even people who have type one, who have, who have tried it before, but not currently there, but feel like inspired to sort of do it again, like anything that you can sort of say that might, I don't know.

01:04:57
move the needle for them? Well, I think that it's possible. So the positive I have is that what we know now is that it's possible for any person with type one diabetes to be as healthy as any non-diabetic. And you know, Bernstein is that example. He is, you know, he's 89 years old and living this fantastic, exciting life.

01:05:28
you know, working and contributing and doing all these human activities. But we all, we also see so many other examples, you know, Dave is, is like an incredible example of someone who was able to meet all his, his academic and athletic goals. And, and there are, there are tons of people out there that are proving that, you know, these flat lines that you see on the CGM,

01:05:57
They are everywhere. And people are, you know, just as I would say that the professional diabetes advocates, the ones that are paid by the diabetes industry, are so awful because they don't allow this information to get out on the flip side of the coin. The low carb people are so eager to help people.

01:06:23
because they've escaped this nightmare themselves and they don't want anyone else to have it. So my advice to people is that they can do it and that they should reach out to somebody. The resources are out there on the internet now. They were not out there 10 years ago. We put the resources out there and now there are people out there. And if you see one and if you message them on Facebook, there will...

01:06:52
be a crowd of people on your doorstep to help you learn how to use insulin, learn how to cook, learn how to change your life for the positive. It's a beautiful thing. Yeah, that's so great, Adi. And hopefully this warms your heart is that whilst I was just sort of searching the internet and just sort of Googled Bernstein's book, just to Google it, I have a copy of it actually, I did come across it on the Australian Diabetes Foundation page.

01:07:22
as a diet to explore if you've got type 1 diabetes. So there was a much more positive spin on it. It wasn't front and center, but it was an option for people, which is way better than the first example I gave you, I think. I was surprised. That's good. Yeah. Yeah. That's good. So Adi, where can people find you and find information? What are the best links for people to explore? If you Google my name, that's one way. Yeah. You can Google

01:07:50
Type one grit. That's another way. Perfect. I think if you if you want to learn more about how to properly manage the type one kind of condition, then you can watch the Diabetes University videos on YouTube. Yeah. Dave has a great video for a kid, a teenager especially. He's got a video at low carb. Google low carb down under Dyckman. OK. Dave Dyckman.

01:08:20
Awesome. And it's Dave, Dave's walking through his, his daily routine. So he's talking about how he does every, all the mechanical things, you know, how he loads his syringes, how he, how he gives insulin, how he takes his, how he takes corrections, how he corrects for lows, how he interacts with his friends. That's a really good video. Awesome.

01:08:44
Awesome. We'll link to all of those things in the show notes and of course, Dr. Bernstein's book as well and the paper that was published on Type 1 grit and your study that got headlines in Washington Post was the most emailed study yet no one gave you a call about that. So that's super interesting. So Lassie, actually, do you have any projects on the horizon ideas that just business as usual for you? Yeah. So that's a good question.

01:09:13
So I have both my sons. I'm kind of fading back into my nerd physics world. And, but Dave, so you mentioned this pediatric study. So that was led by a Harvard professor, Belinda Linares, and she's like a real hero. And Dave went to study with her this summer after his freshman year at Baylor. He spent the summer in Boston.

01:09:42
interning with her. And then I have another son who's not a type one, but he's a senior in high school and he eats as low carb as Dave does. And he's been working with some people in Australia, Gary Fedke on writing a paper on type one and a couple other people, Jane McDonald. And then he's been working, we're going to hopefully start working with Dr. Westman on a low carb

01:10:12
guidelines. So he's, and he's also working with Belinda again, Linares, Professor Linares on, if you, let's see, if you Google Hayden Dykman, physics of injected insulin, he's developed mathematical models discussing everything that we talked about with why insulin works good for low carb. So amazing. Thank you. Both my sons are kind of been taking over for me. That's great. That means that you'll be able to.

01:10:41
do your theoretical physics, whatever that looks like, and go on a cruise, I understand, at some point, when you do your, when Hayden sort of flies from the nest. Yes. Adi, thank you so much for your time. I really appreciate it. And I think just the more that people have this information out there, the easier it is for them to make that step, that it just makes it so much more accessible. So I really appreciate your time. It's awesome.

01:11:10
Okay, it was really, really great. Thank you.

01:11:24
Alright team, hopefully you got a lot from that, either for yourself, for a family member, or for anyone else that you feel would benefit from this information, absolutely tell them to check it out. It is just, it's super powerful stuff. And you might recall, and I think I mentioned it in the chat, that I also talked to Andrew Kucnick about type 1 diabetes and using a low carb approach for management.

01:11:52
This was maybe back in 2021, I believe. And Andrew talked about how Type 1 grit gave him the inspiration that helped him with his own sort of inspiration and motivation for following a low carb approach. So I found that super cool. All right, so next week on the podcast, I talked to one of the goats of the Physique and Body Transformation Spaces. That is,

01:12:21
Brandon de Cruz. So you are gonna love this conversation I have with Brandon. That is next week on the podcast. Until then, you can catch me over on Instagram, threads and Twitter, @mikkiwilliden, over on Facebook @MikkiWillidenNutrition, or head to my website, mikkiwilliden.com. Don't forget to sign up for my webinar series as we head into February and Mondays matter. All right team, you have the best week. See you later.