Patient: Gloria Fleming, Saint Gabriel, LA
Clinician: George Bray, M.D., Chief, Clinical Obesity and Metabolic Diseases (Diabetes), Pennington Biomedical Research Center, Louisiana State University
Specialty: Clinical Research
Twenty-five years ago, Gloria Fleming had a feeling that something was wrong with her health. She was tired all the time, even after a good night’s sleep, and was constantly thirsty. An active woman with young children, Gloria immediately took her complaints to her primary care physician. What she heard was something that more than five members of her family had heard over the years, “You have diabetes.”
Familiar with diabetes, she took the diagnosis in stride. After all, she had seen so many family members, including her mother, living with diabetes that surely being diagnosed with diabetes was more of a nuisance than a wake-up call. Consequently, she continued with her lifestyle of eating greasy and fatty foods and not exercising regularly. “I was a big eater. I ate large portions of bad foods. And because I was never put on insulin, it was easy to ignore the diabetes.”
As time went on, Gloria’s diabetes became more of a problem, forcing her primary care physician to put her on a three-drug diabetes therapy to control her blood sugar. For Gloria, diabetes medication was sufficient to manage her disease and she relied on the medications to “do all the work,” despite the challenging side effects. Exercise and diet were still not a large part of her life.
Then, about three years ago, Gloria was watching television and saw an ad looking for volunteers to participate in a diabetes clinical trial. Gloria consulted with her primary care physician and together they agreed that participating could bring some tangible and positive results to Gloria’s diabetes treatment. Gloria later found out that she was a participant in “Look AHEAD,” a National Institutes of Health-funded, multi-center trial examining the effect of lifestyle interventions on weight loss and management and overall health risk in those with diabetes.
One of the primary investigators of the Look AHEAD trial is Dr. George Bray, an endocrinologist who has dedicated his professional career to understanding the role of diabetes and obesity. He leads one of the 16 centers involved in the 10-year diabetes trial and monitors changes among each of the 343 diabetes trial participants. Specifically, Dr. Bray and his colleagues are looking at whether or not intervention, through diabetes prescription medication, intensive exercise, behavior modification or diet modification, will help trial participants achieve a 10 percent or more weight loss, and ultimately live longer with diabetes and/or reduce their risk for developing heart disease.
“It’s a research trial looking at lifestyle interventions as a way to see if people with diabetes can benefit long term from weight loss,” says Dr. Bray. “This diabetes trial is very important because we need clinical evidence to show that weight loss isn’t just a good idea, it is, for many, a life-saving requirement.”
Clinical and observational diabetes trials are vital to guiding physicians and other healthcare providers to appropriate and effective treatments. For those with obesity-related diseases like Gloria, research is looking beyond a patient’s caloric intake levels and into the realm of interlinking systemic disorders. What makes someone with diabetes more at risk for heart disease? What role does obesity play? Can one really extend their life expectancy if they achieve weight loss of 10 percent of their body weight? Long-term studies like the Look AHEAD diabetes trial are critical to bringing light to these issues and their possible solutions.
Gloria’s participation in the diabetes and weight loss/management trial means regular check-ins with Dr. Bray and his team, blood work, food measurement, an exercise routine and group discussions among those in her treatment group – all in addition to continued care from her primary care physician.
“I wanted to be in the trial because I knew it was going to be good for me,” says Gloria. “But the encouragement and enthusiasm I was getting from Dr. Bray and his team,” (which includes nurses, behaviorists, psychologists, registered dietitian and exercise physiologists), “made me want to improve for them too. They put so much into the program – they really want you to succeed. So I knew that I had to do my homework or else I’d be letting them, the group and myself down. The trial is like a family and we all support and cheer each other on.”
For Gloria, this diabetes trial has changed her life. In the two years that she’s been a Look AHEAD participant, Gloria has achieved more than just physical improvements – she has regained her sense of self and what it means to have control over your diabetes and your health.
The changes haven’t been easy. “In the beginning,” said Gloria, “my moods and enthusiasm levels were on a roller coaster. I was up, then down, then up again. It was tough and I know I wasn’t any fun to be around. But after a few months, my health and my moods calmed down and I was fun to be around again.”
To date, Gloria has achieved weight loss of 25 pounds and has been taken off two of her three diabetes medications. Her blood levels are consistently at normal levels and she is physically satiated with smaller meals. Gone are the big-portioned meals of fried foods. She can now eat less and still be satisfied.
“If I hadn’t been in this program, I’d still be making the wrong choices. I’m 66-years-old, and I want to live long enough to see my grandchildren graduate from college, and enjoy life in the process. I’m happy to say that because of this trial, my biggest problem isn’t my health anymore, it’s what to do with all those clothes in my closet that don’t fit!”