Thursday, August 30, 2001

Peter Ho, above, is tested for diabetes at Queen's Medical Center
by Renee Latimer, a registered nurse.

Change for the best

A diabetes prevention study
leads 2 local men to
healthy habits


By Helen Altonn

Two Honolulu men who participated in a five-year national Diabetes Prevention Study say it changed their lives "big time."

Bruce Hicks, 51, of Pearl City and Peter Ho, 57, of Waialae Iki were among 74 Hawaii volunteers in the clinical study.

It ended a year early because of dramatic findings that diet and exercise can delay or prevent Type 2 diabetes.

Facing a national diabetes epidemic, the American Medical Association authorized immediate release of the results instead of waiting for them to be published officially.

Hicks, a real estate broker, said the study taught him that he "can do minor changes in my diet and make major changes in my lifetime."

Ho said he retired at age 54 from his high-stress job as city traffic engineer partly to join the study and now realizes "living well is fine, but being well is better."

All 3,234 volunteers nationally had impaired glucose tolerance, putting them at risk for diabetes. They were assigned randomly to medication or lifestyle groups.

Hicks is one of 24 Hawaii participants in a continuing lifestyle group. "I'm so thankful for having got into the program," he said, "because I was on a downhill run, gaining weight, going toward diabetes."

Bruce Hicks checks his weight at Queen's Medical Center.

Ho is one of 40 either using the drug metformin (Glucophage) or a substitute. They didn't know which, and Ho still was in the dark when interviewed for this story. He learned later that day that he has been on metformin since joining the study four years ago.

"He was shocked," said Renee Latimer, a registered nurse who coordinates the program. "He thought he was on a placebo and had a plan to go into lifestyle intervention."

Another 10 islanders were in a group using the drug troglitazone. It was halted in 1998 because of possible liver toxicity.

The local volunteers included 24 Pacific Islanders, 31 Asian Americans, 17 Caucasians and two Hispanic residents.

Latimer said those using metformin are asked to continue taking it because it reduces the risk for diabetes. But as the study continues, she said, "we will be offering lifestyle to everybody. It's almost twice as effective as metformin. But we will do it in a group instead of individually."

The goals are a 7 percent weight loss through a low-fat diet and 150 minutes of exercise a week.

Hicks and Ho said the volunteers have received "tremendous" staff support and have been "very well monitored." Dr. Richard Arakaki, University of Hawaii professor of medicine, directs the program, based at the Queen's Medical Center.

The lifestyle group still meets once a month. Those on medication reported every three months for a checkup, and all volunteers had a blood test every six months. Once a year, they had a full physical with CAT scans. An annual "appreciation lunch" is held for all participants, said Uilani Twiggs, the program's retention coordinator.

Hicks said he volunteered for the study three years ago because his life was "a roller coaster ride," a family history of diabetes and devastating effects of the disease on friends.

He was doing nothing to improve his health, he said. Now he walks 180 minutes a week, hikes three to five miles with the lifestyle group and boogie-boards with his son. He tried skateboarding, but broke his ankle in four places and was on crutches for three to four months.

Dietary changes helped to lop 20 pounds from Hicks' weight. He said he's probably reduced his meat intake by half and eats that many more vegetables.

Ho said his wife, Victoria, heard about the study and thought he should lose some weight because his mother and several siblings have diabetes. He agreed "it would be a good idea to get some discipline."

Although "assigned to the pill group," Ho said he "took it upon myself to exercise and diet" and has lost 10 pounds.

He golfs once a week, walking 27 holes, plays tennis twice a week and snorkels and kayaks -- "more on an average than a person in the lifestyle group," he said.

He tries to follow the study's food recommendations, which he said are similar to Dr. Terry Shintani's Hawaiian Diet.

All trial participants had to record their exercise and everything they ate, with fat grams, in a "month of practice" before being selected for the program, Ho said. They were also tested on taking medicine.

Lifestyle volunteers have continued to submit reports of all their food and exercise for one week every month, Hicks said.

"One of the best things I got out of this whole thing," he said, was to learn how to reduce fat from hamburger cooked for pasta or another dish. "After you cook it, you put it in a colander in hot water and wash off the fat, and it goes from 80 percent to 96 percent lean."

The lifestyle group also learned how to order fast foods, Hicks said, noting containers of fat from such products as hamburger and chicken katsu were displayed at one meeting.

"The amount of fat shook me up so much, I stopped eating Whoppers. Now, I order it with no mayo, heavy on tomato."

Hicks said his wife, Vanessa, and children -- Reid, 12, and Kanoe, 20 -- are all fat-conscious now and study grams on cans when they go to the market.

In restaurants, he asks if they serve brown rice and if the cook will cut back on oil. "It's surprising. A lot of restaurants will cut back on oil. If you say you're on a special diet, they'll accommodate you."

Ho said he'll continue with the lifestyle follow-up study. "What I've got to learn from these guys is proportions."

"They're tiny," said Hicks.

Just being part of the study has changed the type and quality of the foods he eats, Ho said.

"I don't think I can eat a big T-bone steak anymore."

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