Articles
Telephone Interview With Richard
K. Bernstein, M.D.
914-698-7500
October 7, 1999
diabetes@scientist.com
Charlie Suther is a nice guy. Maybe 30 years after he
started working with diabetes he developed type 2 diabetes. I’ve been
working on him for years to try my new patent for weight reduction
and treating carbohydrate craving.
Many times [self-testing of blood glucose] has been
called the most important thing since the discovery of insulin.
I went to medical school because I couldn’t get published.
Self-monitoring was especially feared by the ADA. My
doctor was the president of the ADA.
Who was he? Max Ellenberg (sp). I can mention
his name because he’s now deceased. He was very much opposed to self-monitoring.
Most of the people connected to the ADA were even viciously opposed.
Charlie may not have told you that, but the top people threatened
Charlie when he started circulating the self….I published an article,
self-published because no one would publish it, on how to normalize
blood sugars in type 1 diabetes, and he pedaled the pavement carrying
this article. I made a couple of hundred copies. They had to be offset,
because we didn’t have the kind of copy machines that we have now.
We had the thermofax thing. We couldn’t get nice copies. He took it
around to all the major universities and diabetes investigators and
the ADA heard that he was doing that and threatened that if he continued
to push self-monitoring, no, if they were to sell a meter to patients
that they would formally recommend Lilly’s TesTape over the Ames system
for testing urine. They had been neutral in the battle between the
Ames system and Lilly’s TesTape system, but Charlie was told, and
you can confirm this with him, that if they were to try to sell the
meter to patients, the ADA would recommend the Lilly system over the
Ames.
The ADA fought this tooth and nail until they caved
in slightly in 1986, I believe it was October. There was a joint meeting
of the ADA and AADE, that is representatives of the ADA and AADE and
a few other organizations, and by this time the demand from the patients
was so great that the ADA caved in and said that they would find self-monitoring
as an acceptable mode of treatment for those who take insulin, just
those who take insulin, which automatically ruled out 90% of diabetics,
and that was in 1986, 17 years after they first knew about it.
When did you get your first meter? I ordered
it in 1969, in October or November. And I received it, I believe,
in January 1970.
And that was an A.R.M.? Yes, and I have it right
up here in my office. I have a museum of all the old meters. That
had a built-in battery. And when the reflectance meter came out and
I started using it for people…two research studies, one at Rockefeller
University and one at the downstate division of SUNY, the State University
of New York. The reflectance meter was no longer available, and we
no longer had a portable meter. So I took battery packs from two 9-volt
Radio Shack rechargeable batteries. They needed something like 15
volts, but if you put the two 9-volt meters in series you got 15 volts.
And as the patients would be recharging, they had two sets. One would
be in the meter and the other would be recharging at home. And I still
have one of these little battery packs.
The problem for patients to get one of the early
meters is that they had to have a prescription, and you were in the
fortunate position that you have an M.D. wife. But which company had
the first meter available on a non-prescription basis, and when was
that? Okay. I have it right here. It’s called the Glucochek. No
one in this country wanted me around with this heresy. So I got Zvi
Laron in Israel, who still has an annual juvenile diabetes conference.
And I sent him this article that I couldn’t get published. And he
invited me to come and speak at his conference in Israel. And that
was around 75 or 76. He had a satellite conference after the main
conference for the European Association for the Study of, I think,
Pediatric Endocrinology or it may have been Diabetes. I gave a presentation
at his main conference and got the Ames people from Europe interested
in stocking the meter and making it available to patients. They didn’t
even have a meter at their booth. They were just selling urine testing.
The next conference in Israel a year later they had these meters on
display for use by patients. But at the first conference, the small
one, the satellite conference, there were some people from England
who were very interested in this concept. And they actually got a
parent of a diabetic to fund the development by an electronics company
of a portable meter, not a big one like the reflectance meter, but
a real pocket sized portable meter, and it came out. It was called
the Glucochek. That was probably in 1976, maybe 1977. It had one problem.
The timer was inaccurate. It had a built-it timer and it was grossly
inaccurate. And I still have one here, and here is my calibration
curve on the back of it. That was probably 76 or 77. So in England
these things were available for patients. The Ames meter was available
in England and throughout Europe and the Near East, because of their
sales manager, whom I introduced to it. Now, did they do publicity
for this? Probably not. But their salesmen were pitching it to the
doctors to make available to patients.
When was it first made available in the United States
on a non-prescription basis? Probably, I believe they started
making smaller meters when I was in medical school. The first one
I have here, the Ames Dextrometer came out when I was in medical school.
That was probably in 1979. But a prior one, the Ames Glucometer, was
available in England at the same time as the Dextrometer was available
here. The Glucometer was a superior meter. They did separate consumer
research. And you know how these big companies always find out nonsense
when they do these consumer research things. They don’t ask the right
questions. And the Glucometer was developed for use in England because
the consumer research was different there than here. And it was a
much superior instrument. It was available from Ames in England, deliberately
made for consumers around 79, maybe 78, and it didn’t became available
here until years later, when the found the Dextrometer was a bomb.
Why does the conversation between Dr. Miller in
Michigan and Ted Doan considered by several people as the real breakthrough
in meters? I would think that it was the breakthrough in bringing
LifeScan into the picture. That is probably what it was. LifeScan
didn’t come out with a meter until I started in practice. That was
around '83.
What’s special about LifeScan? Was it that they
really went after the patients? Their marketing was better? I
think it was easier to use and smaller.
And around that time the Accu-chek series first came out from Boehringer.
One of them was superior to the Ames products. The LifeScan products
were always mediocre in terms of accuracy. And they still are, but
don’t quote me.
The Elite is the best one, the most accurate on the
market. The Elite has been the best since the first Elite came out.
Before that it was the Ames. I was always testing meters, and their
meters were not accurate. They are down the road meters. And finally
the Elite was fabulous.
One of the main reasons why I started all the blood
sugar measurements was all the hypoglycemia. My family was mad at
me. I made them miserable, terrified.
My whole reason [for going to medical school] was because
I couldn’t get published. I tried desperately to get the substance
of my first book. I got it boiled down to 10 typewritten pages and
no one was interested.
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