You can have a good A1C - (around 6.0) and still have highs and lows. You can still be on a bs roller coaster. This fluctuation in blood sugar can take a toll on your body as well. Right now my bloods are at their best and if my blood sugar even starts to approach 200 I feel like cramp (I'll start feeling lethargic at about 150-160). It's when my blood sugar is high that I feel my brain isn't functioning at it's best (then of course when it's low around 50 I start to have problems). Reducing the carb intake decreases the post meal high. Using the CGM has given me wonderful insight on how high I was going after eating a good amount of carbs in one sitting. In an effort to keep my bs on the tightest control I've decreased my daily in take of carbs even more which makes me feel better. (If my sugar stays between 80-130 I feel soooo much better than if it ranges from let's say 50-200). My A1C hasn't changed much. I still stay in the 5's. But of course everyone is different. I've been very fortunate to be very healthy besides having T1. My blood pressure is low. My chloresteral is almost too low. My kidney functions are good. So I don't worry about heart disease, etc... from eating a low carb diet. I also am working in an office so my activity level is somewhat limited. So I just don't find a need to eat 130 grams of carbs a normal day. I do randomly test for ketones with no avail. Believe me when I'm trying to drop a few pounds I wish I could detect some.
I will agree that I don't think young people should be on Dr. Bernstein's diet either. Some of the foods on his no good list I believe are necessary. I think his diet is geared towards diabetics that suffer from severe complications. I've taken his recommendations and I follow a low carb diet but it's a diet that I can live with and I don't feel deprived.
Secondly I didn't think Dr. Bernstein went to medical school just to put Doctor in front of his name for the purpose of selling his books. I believe he began his career as an engineer and his wife was the doctor. He took a very analytical approach to treating himself because he wasn't satisfied with the doctors telling him that his complications were to be expected. He went against the conventional thinking of the medical field. He was his own guinea pig and he saw the benefits to following a very regimented lifestyle (which is extremely difficult to do).. He later when to medical school and became an endocrinologist.
I agree with you, you can have a low a1c - but how many lows are you having? The swings that come with taking in large amounts of carbs aren't worth it. I too have excellent bloodwork, my cholesterol is perfect, kidneys great, blood pressure excellent. I also test for ketones, and like you nada. I eat more vegetables and salad than most non diabetics I know and am healthier then them also. I never feel deprived, and have no cravings. My husband had high cholesterol and is also on a low carb diet, his numbers are now perfect, and his doc agreed, it's the diet that brought it down. More and more doctors are finally realizing the benefits of tight control.
And yes, Dr. Bernstein became a doctor because of his frustration with the medical community telling him to "deal" with the consequences of his complications. Not because he wanted to sell books. Again, it works great for some, some can't do it.