In Memory of Dr. Richard K. Bernstein, April 17
Wood M, Ebe K and Bando H
Published on: 2025-04-27
Abstract
Dr. Richard K. Bernstein, physician with Type 1 Diabetes (T1D), faced complications from conventional high-carbohydrate diets until he self-experimented with a Low-Carbohydrate Diet (LCD) approach. Becoming a doctor at 49, he authored numerous articles and books promoting LCD for diabetes management. His work suggests improved life expectancy for T1D. In Japan, persistently suboptimal treatments underscore the need for carbohydrate-controlled diets, a cause advanced by the Japan LCD Promotion Association (JLCDPA).
Keywords
Type 1 diabetes; Low carbohydrate; Multiple daily injections (MDI); Self-monitoring of blood glucose (SMBG); ComplicationsCommentary
In Memory of Dr. Richard K. Bernstein, April 17
- Richard K. Bernstein, a type 1 diabetic, passed away on April 15, 2025, at the age of 90. Sincere prayers are offered for his eternal rest.
- Bernstein’s books have provided a wealth of knowledge about diabetes, earning deep gratitude from those who have benefited from his work.
- Bernstein was born on June 17, 1934. Diagnosed with type 1 diabetes (T1D) at the age of 12, he lived an exceptionally long life for a type 1 diabetic of his era [1].
He authored the following books on diabetes:
- The Diabetes Diet: Dr. Bernstein's Low-Carbohydrate Solution (2005)
- Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars (Hardcover, 4th ed., 2011)
Both books have been translated into Japanese [2,3].
Dr. Bernstein was diagnosed with T1D in 1946 at age 12. He consulted diabetes specialists and followed the conventional “low-fat, high-carbohydrate diet (45% of calories from carbohydrates)” combined with large doses of insulin injections for over 20 years. As a result, in his 30s, he developed proteinuria, progressing to stage 3 diabetic nephropathy, along with various other complications. During this period, he suffered from frequent hypoglycemic episodes, and his proteinuria steadily worsened.
In 1969, at age 35, a newly released blood glucose meter became available. Leveraging his background as an engineer, Dr. Bernstein spent three years meticulously studying the relationship between blood glucose levels and diet. At the time, the concept of preventing diabetic complications through blood glucose normalization was nonexistent. However, a turning point came when he discovered a paper on animal studies showing that normalizing blood glucose could prevent and improve complications. When he shared this with his doctor, he was told, “Animals and humans are different; normalizing human blood glucose is impossible.”
Undeterred, in 1973, 27 years after his diagnosis and at age 39, Dr. Bernstein began using his own body as an experimental subject to maintain normal blood glucose levels by adjusting carbohydrate intake and insulin doses. Through various self-experiments, he developed methods to keep his blood glucose within normal ranges. Ultimately, he adopted a strict low-carbohydrate diet, dramatically reducing the insulin doses prescribed by his doctor and achieving his goal. His proteinuria improved and eventually disappeared, and the chronic fatigue that had plagued him for years vanished.
Eager to share his findings with other diabetic patients, he submitted papers to medical journals, but they were dismissed. Realizing that his lack of a medical degree undermined his credibility, he resolved to become a doctor. In 1979, at age 45, he enrolled in Albert Einstein College of Medicine. He became a doctor in 1983 at age 49, dedicating himself to researching diabetes treatment, opening a clinic, treating numerous patients, and publishing books based on his data to promote diabetes management centered on a strict low-carbohydrate diet. This diet saved Dr. Bernstein’s life, a type 1 diabetic for whom conventional treatments had failed.
A significant difference in the life expectancy of type 1 diabetics can be seen when comparing a 1975 study [4], with a more recent study published in 2015 [5]. If low-carbohydrate diets were widely adopted among type 1 diabetics worldwide, their life expectancy could improve dramatically (Table 1).
Study Details |
1975 U.S. Study |
2015 University of Dundee Study |
Location |
United States |
Scotland |
Sample Size |
Not specified |
24,691 type 1 diabetic patients |
Life Expectancy Reduction |
27 years less than healthy individuals |
Men: 11.1 years less |
Comparison to Healthy Individuals |
Significant reduction |
Reduced gap, indicating improvement |
Implications |
Historical baseline |
Shows progress in life expectancy >40 yrs |
Observations from Japan indicate challenges in T1D treatment. At a lecture by a university professor specializing in T1D, six pediatric cases were presented, all of whom experienced frequent hypoglycemic episodes. The professor discussed this calmly, which was surprising. It is understood that while hyperglycemia is harmful, hypoglycemia is even more damaging to the body. Even if a strict low-carbohydrate diet is not feasible, adopting at least a carbohydrate-controlled diet could reduce the frequency of hypoglycemia. Unfortunately, this approach was not implemented. The prevailing philosophy among Japanese diabetes specialists appears to be: “Administer insulin so children can eat bread, cakes, ice cream, ramen, or white rice like other children.” Without adopting a carbohydrate-controlled diet, determining the appropriate insulin dose for the amount of carbohydrates consumed is difficult, likely leading to frequent hypoglycemic episodes. As a result, many type 1 diabetic patients in Japan are likely receiving suboptimal treatment.
The Japan Low-Carbohydrate Diet Promotion Association (JLCDPA) is actively working to promote the adoption of low-carbohydrate diets in Japan. Medical institutions supporting low-carbohydrate diets are now available from Hokkaido to Okinawa [6,7]. Efforts continue daily to create an environment where both type 1 and type 2 diabetic patients can easily access low-carbohydrate diet treatments.
References
- Dignity Memorial. Richard Bernstein obituary. Forest Hills (NY): Sinai Chapels. 2025.
- Bernstein RK. The Diabetes Diet: Treatment with a Low-Carbohydrate Diet. Ota Y, translator. Tokyo (Japan): Saiensusha. 2009; 263.
- Bernstein RK. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. Shibata T, translator. Tokyo, Medical Tribune. 2016.
- Livingstone SJ, Levin D, Looker HC, Lindsay RS, Wild SH, Joss N, et al. Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. JAMA. 2015; 313: 37-44.
- Goodkin G. Mortality factors in diabetes. A 20 year mortality study. J Occup Med. 1975; 17: 716-721.
- Wood M, Ebe K, Bando H. Adherence to medical and dietary therapy in type 2 diabetes patients. SunText Rev Endocr Care. 2024; 4: 119.
- Wood M, Bando H, Ebe K. Beneficial effects of low carbohydrate diet (LCD) with recently emerged solid evidence. Asp Biomed Clin Case Rep. 2024; 7: 65-68.