For Tim Daly (left), losing 14 pounds brought his blood sugar down from pre-diabetic to the normal range. His identical twin Paul (right), works to manage his diabetes with exercise.
"If it's hard to imagine how small differences in lifestyle can make a big difference in your health, consider this story of identical twins Tim and Paul Daly. They shared almost everything in childhood, including the same eating habits, the same love of basketball, and the same genes--some of which predispose them to diabetes."
"Preventing Diabetes: Small Changes Have Big Payoff", by Allison Aubrey, NPR Morning Edition 1/04/10
I heard this story while driving into work on Monday morning. It put a big smile on my face! Frankly, we all have one kind of disease or another in our family closet, and who doesn't want to think we can have at least some control over our health. Well here's how to foil the diabetes gene!
Turns out diet and exercise can trump the diabetes gene. And diet and exercise was twice as effective as medicine in preventing diabetes!Here's the story of the Daly Brothers of Massachusetts:
- Tim and Paul Daly are 60 year old identical twins--born in 1949.
- At age 24 they were both in excellent shape--5' 10" tall and both weighing 147 pounds. From that point on their lives took a slightly different direction.
- In their 30's & 40's they both started putting on weight--Paul gaining more than Tim. At age 47 Paul weighed 220 pounds. Tim weighed 200 pounds.
- Since Paul's wife worked nights, while he worked days, he ended up eating more fast-food and convenience food than was good for him, and he got zero exercise. Note added 1/6/10: Apologies if this sounds like wives are responsible for the health of their husbands--it wasn't meant it. This was Paul's take on why he was making "less healthy" choices.
- Tim played basketball every Tuesday night with his buddies for 1 hour a week.
- By 1996, at age 47, Paul's weight had climbed to 220 pounds. He'd gone from 185 to 220 in a blink of an eye. At his annual physical he was diagnosed with type 2 diabetes, with nary a symptom.
- The complications of diabetes terrified him: Loss of vision, kidney failure, amputations because of an effect on the nervous system, and a substantial increase in the risk of stroke and heart disease.
"Because we know that type 2 diabetes is a genetic disease, and since he (Tim) is an identical twin, he has a risk of developing diabetes that's about 95%."
-Dr. David Nathan, Director of the Massachusetts General Hospital Diabetes Center-
How Tim Daly Beat the Curse of the Type 2 Diabetes Gene
- Lucky Tim. Soon after twin brother Paul was diagnosed with diabetes, Tim jumped at the chance to participate in a large 27-site national diabetes prevention study for people at high-risk of developing the disease.
- 3,234 volunteers were divided into 3 groups: One group got intensive counseling from a dietitian and a motivational coach who helped develop a plan to eat less and exercise more. A second group took the diabetes medicine Metformin twice a day. A third group received placebo pills instead of Metformin.
- Lucky Tim. He got into the diet & exercise group.
- Here's what his dietitian & coach prescribed for him: 2 and 1/2 hours of exercise a week + he had to lose 14 pounds--7% of his body weight. At the start of the study he weighed 200 pounds--too much for someone who's 5'10". As for the exercise--since he was already playing basketball 1 hour a week, he added some brisk walks and jogging a couple of miles a week. He also started walking the golf course instead of using a cart.
- When Tim started the study back in 1996 his blood sugar test showed he was pre-diabetic--with blood glucose levels that were higher than normal--but not yet "worthy" of a diabetes diagnosis.
- Adding more exercise into his week wasn't the hard part for Tim. The tough part was learning to eat smaller portions--all the time. He had to turn that into a habit. He learned the drill--a portion of meat is the size of a deck of cards. When he wanted potato chips, he learned to pour a small amount into a cup--no more eating out of the bag.
- Losing the 14 pounds moved Tim's blood sugar into the normal range--out of the pre-diabetes state. Nothing too daunting. A small change made all the difference.
- 14 years after starting the study, Tim is still diabetes-free.
Diet and Exercise or Metformin or the Placebo. Which Group Fared the Best?
- The study found that diet & exercise was twice as effective as taking the Metformin in preventing diabetes in the volunteers.
- The point of the study was to encourage life-long habits and behavioral changes--not just put the volunteers on a short-term diet.
- For the other volunteers, all with pre-diabetes, losing 7% of their body weight helped to cut the risk of diabetes by almost 60%. Tim's results were typical of the other diet/exercise participants. Small changes--losing 14 pounds in Tim's case--not 50 pounds, made all the difference.
- According to Dr. Nathan, eating better and exercising is incredibly effective in helping to manage type 2 diabetes and pre-diabetes. When people lose weight, their blood sugars respond favorably.
- "Small steps can result in really large benefits. Just doing a little more will help enormously to prevent this. And that's what the Diabetes Prevention Program showed," according to Dr. Nathan
- Although Tim has dodged the diabetes bullet now for 14 years, Dr. Nathan says researchers are still studying whether or not it's possible to keep diabetes at bay for the rest of his life.
- With 1.6 million new cases of diabetes diagnosed per year in the U.S., Dr. Nathan hopes people will begin to understand how such small life-style changes can have such a tremendous effect on one's future health.
And What About Brother Paul?
- Since Paul already has type 2 diabetes his battle is tougher, and he's vowed to try harder.
- He's stepped up his exercise, and is kicking up his daily walks a notch.
- Because Paul is exercising more, and eating better, he's been able to manage his diabetes, and doesn't need to take insulin.
- There's strong evidence that even exercise, without weight loss can help improve blood sugar.
The experts: Gerald Shulman of Yale University School of Medicine & Arthur Leon of the Univ. of Minnesota
- Exercise can prevent and even reverse Type-2 diabetes
- Again, it's all about insulin resistance. Too much body weight or a not-so-healthy diet & insulin-resistance develops--then the body can't absorb all the glucose from your digested food. This leads to a build-up of fats in the body which further interferes with the whole glucose transportation system. If the body can't absorb all the glucose in the blood, bad things can happen: like heart disease, nerve damage, blood vessel damage, stroke, or infections.
- Exercise can reverse the whole process. With vigorous exercise the muscles increase production of an enzyme called AMPK, which breaks down the fats that were interfering with the cells' glucose transportation system. Bingo--the body starts responding to insulin and absorbing glucose just like it's supposed to do.