Q&A With Dr. Richard Bernstein

What is the best way to overcome insulin resistance?

Answer: The most common cause of insulin resistance is obesity due to abdominal and intramuscular fat. The best way to overcome it is to lose weight. In addition, the second best way, is to exercise and build muscle mass, because muscle mass increases insulin sensitivity. If you are lowering your body fat, you’re diminishing insulin resistance.

So, the combination of exercise and weight loss is great for reducing insulin resistance. Medications such as Glucophage, Actos, and Avandia also reduce insulin resistance.

What is the variant of hemoglobin that is not compatible with the A1c test?

Answer: There are a number of abnormal hemoglobins that some humans can make. The most common is Hemoglobin F, which is the hemoglobin that infants make.

If you want to know your hemoglobin profile, the test is called hemoglobin electrophoresis. The great bulk of people whom I’ve tested were not making significant amounts of unusual hemoglobins.

What is the best test used to detect diabetes and pre-diabetes?

Answer: I like the hemoglobin A1c. I received a news release that the American Diabetes Association is finally going to be recommending it for diagnosis of type 2 diabetes. I’ve been pushing this for years, and I would use it for diagnosing any kind of diabetes.

If you have a relative whom you think is susceptible, I would check A1c every year. If it comes in above 5%, I’d be concerned. If it increases every year, I’d be concerned. Normal A1c is 4.2- 4.6%, not the ADA guidelines.


Richard K. Bernstein, MD is one of the most knowledgeable, committed, and successful pioneers in the field of diabetes today. He invented blood sugar self-monitoring and basal/bolus insulin dosing when he was an engineer.

Dr. Bernstein is Director Emeritus of the Peripheral Vascular Disease Clinic of the Albert Einstein College of Medicine in Bronx, NY. His private medical practice in Mamaroneck, NY, specializes in treating diabetes and obesity.

He is a physician, research scientist, thriving type 1 for 67 years, and best-selling author of nine diabetes books including Diabetes Solution, The Diabetes Diet and several e-books. This link diabetes-book.com will give you more information about his publications. To sign up for his free monthly tele-seminars, visit askdrbernstein.net

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