Generational Gene: Cycling for Diabetes Prevention

Gene

And so I really do see the relationship between exercise and prolonging my life as a parent.

Valerie Wencis (co-host)

Gene is a public school superintendent, he’s getting a doctorate, and he’s also a devoted dad.

Gene

Well, I think my daughter definitely enjoys soccer and gymnastics. And so I think she definitely inherited interest in doing things physically.

Valerie Wencis (co-host)

He’s also a devoted son.

Gene

I can count on every morning my dad will text me to say good morning, which is one of those things I think that it can be easy at times to take for granted.

Robert Pease (co-host)

A lot of love in Gene’s family across the generations. He’s inherited that deep commitment to family and also an understanding of his elevated risk for diabetes, which does have a strong genetic component.

Gene

So my grandfather developed type two diabetes, my father was diagnosed with type two diabetes in the last five years. My dad is now 70. And, four or five years ago, my doctor started talking to me about my A1C level going into the range where you have to be concerned about diabetes.

Robert Pease (co-host)

Gene’s odyssey this episode. Like millions in North America, he has pre-diabetes, meaning elevated blood sugar, or A1C levels. It’s the precursor to diabetes. It’s a major warning sign. So Gene’s working to manage a disease he does not yet have. You’re listening to My Body Odyssey, a show about the rewards and challenges of leading an active lifestyle. I’m Robert Pease.

Valerie Wencis (co-host)

I’m Valerie Wencis, and not unlike most of us, Gene needs to be careful about what he eats and drinks, and consistent in finding time to exercise with a full time job, a family and get good grades in his graduate program.

Gene

Well, you know what, I’m maybe gonna take some time away from work to do this bike ride, but ultimately it’s gonna make me a better employee. It’s gonna make me a better student, It’s gonna make me a better husband, it’s gonna make me a better parent.

Robert Pease (co-host)

We first met Gene in the summer of 2022 at the New England Tour De Cure bike ride put on by the American Diabetes Association. A really warm day, 90 degrees plus at noon; but some shade along the ride, and great camaraderie at the event.

Valerie Wencis (co-host)

After completing 30 miles with friends and raising some money for diabetes research, Gene was generous enough to sit down with us and share his family’s odyssey.

Valerie Wencis (co-host)

And so Gene, this is your first time riding in the Tour de Cure, but you’re no stranger to cycles, it sounds like.

Gene

So I ride the Pan Mass Challenge every year. Actually, that’s completed my fourth Pan Mass challenge. Obviously, we all know so many people have been impacted by cancer and also by diabetes, and that’s something that’s really impacted my family very much. And so it’s a great cause and a good opportunity to build community and do something that I enjoy.

Valerie Wencis (co-host)

That’s great. And you had mentioned, but just so our audience would know, you have – there’s some lineage of diabetes, right? Can you tell us a little bit about that?

Gene

So, my grandfather had diabetes that really impacted his health and his quality of life. And my father now has diabetes and I’m in that kind of pre-diabetic category, which is why I’m out here. One of the reasons I’m out here pedaling some days is that it feels like you pedal to save your life. And in a lot of these sorts of events, you really are.

Robert Pease (co-host)

So much at stake in Gene’s odyssey. But not immediately or obviously at stake. In this pre-diabetes condition, Gene has no symptoms. And that poses a special challenge. We reached out to Dr. Michael Riddell of York University in Toronto on that point. He was so insightful on a previous episode featuring IronWoman Diane, a triathlete with type one or juvenile diabetes. Dr. Riddell has type one diabetes himself and is a leading authority and researcher on diabetes and exercise.

Dr. Michael Riddell

Pre-diabetes doesn’t have a lot of signs or symptoms. There are some clues based on family history of diabetes and a little excess weight gain and inactivity. But other than that, it’s a pretty silent condition that doesn’t give any overt signs or symptoms, like no link with fatigue or frequent urination or no link with really anything. So there’s a lot of people, maybe 30-50% of the population, walking around with prediabetes in the age group, like after age 40 basically.

Valerie Wencis (co-host)

A silent condition which can suddenly develop into a much more serious one. We called Dr. Sheri Colberg, another widely published and consulted expert on diabetes and exercise. Dr. Colberg, like Dr. Riddell, has type one diabetes. We asked her specifically about Gene’s situation.

Dr. Sheri Colberg

Given that you said that his A1C has already been elevated, yes, he’s certainly at higher risk, but there is a lot that he can do and you always gotta keep sight of that. It’s not inevitable, especially if there’s a family history.

Robert Pease (co-host)

A few months after that Tour De Cure, we also reached out to Gene to discuss how he’s doing with his motivation, with his diet and exercise, and with those stealthy blood sugar levels.

Valerie Wencis (co-host)

You had this really great comment when we were at the event. You said some days you feel like you’re pedaling to save your life. And in a lot of ways, you said at these events, you are. Can you expound on that a little bit?

Gene

Your body’s the only one you’re gonna get. One of the things I’ve learned in the last couple years is that cellulose and fat tissue is biologically active, right? And so the more of it you have, the more of it that can impact your body chemistry and your organs, right? You know, the idea that having a comorbidity means that it makes other things more likely to be acute.

Robert Pease (co-host)

Gene was a biology teacher before becoming a school superintendent. He has a deep science background. He understands the risks associated with elevated blood sugar involve not just diabetes but also some forms of cancer. Again, Dr. Riddell.

Dr. Michael Riddell

Not all cancers are linked to blood sugar control, but many of them are, and many of them are also linked to central obesity. Unfortunately, cancer cells love high blood sugar levels. They feed off of it. So it’s a disease cluster that we know can be influenced profoundly by our behavior. Now you can’t eliminate all cancer risks in your life, but you can reduce your risk, your relative risk, if you are more physically active and you have a lean body mass. Absolutely.

Valerie Wencis (co-host)

Again so many people – tens or even hundreds of millions across the world have elevated blood sugar levels and could stand to benefit from being more active. But they may not know that their blood sugar is elevated. In other words, you can be at high risk for diabetes and elevated risk for cancer but they don’t even know it.

Dr. Michael Riddell

It’s so frustrating that people don’t know that they have pre-diabetes. There really are no overt symptoms. And you have to have a heightened awareness yourself about the condition. And many people have never even heard the term before, pre-diabetes. They don’t know what it really means.

Robert Pease (co-host)

We all know we should be more active and eat healthier. But the reality is: only a small percentage of people with prediabetes are able to put that advice into practice.

Dr. Sheri Colberg

Motivation is very difficult. It’s something that all of us struggle with.

Robert Pease (co-host)

Again, Dr. Sheri Colberg.

Dr. Sheri Colberg

Everyone seems to know that being physically active is good for you. I mean, I don’t run across many people who say, oh no, exercise is really bad for me. I would never wanna do that. So then it’s: why is it then because of behavior change, and how do we change behavior easily? It’s not easy to change. It takes a concerted effort.

Valerie Wencis (co-host)

But Gene had an advantage there. He had been a three-season athlete in high school. And a division one track athlete in college. He knows how to work hard at a sport and make progress.

Robert Pease (co-host)

Then again, he’s also not a kid anymore. His body has changed. The sports he did as a younger athlete, like sprinting and football, they don’t work so well for a middle-aged guy in his 40s.

Dr. Sheri Colberg

We’re all losing some muscle mass with aging, particularly those faster muscle fibers, which Gene may have a lot of, if we’re not recruiting them. You definitely lose them over time if you don’t recruit them or use them. And you know, many people, when they get to the age of 80 are sprinting a lot, they’re not recruiting those faster fibers unless they intentionally do it with something like resistance training. So there are lots of different ways to do that.

Robert Pease (co-host)

So the question became, what sport helps Gene move forward on the challenge of moving away from diabetes and cancer risk?

Gene

As I was thinking about eventually wanting to remain an athlete, wanting to remain very physically active and do things that were fun and exciting, but also realizing that a lot of my friends were tearing their ACLs and their Achilles and getting all those old man basketball injuries. And I didn’t think that that would add to my life. So I made the transition into cycling.

Valerie Wencis (co-host)

Cycling would seem to have elements of resistance training, especially up those hills, while also burning a bunch of calories. Not to mention, it’s easier on the joints. We asked Dr. Riddell if all forms of exercise are created equal – that is, in terms of blood sugar management and weight reduction.

Dr. Michael Riddell

Yeah, that’s a great question. We’ve been looking to see if there are certain types of exercise that might be more favorable for reversing this condition. And it looks like thankfully, most forms of exercise are helpful, including weight training or resistance training, and aerobic training where you’re just brisk walking or cycling like Gene is doing.

Valerie Wencis (co-host)

Gene had always had a bike growing up – well, almost always.

Gene

Since childhood, I’ve always loved riding bikes. I remember my first couple bikes as a child were kind of like your ticket to freedom and speed and experience, and also social connection with other kids in the neighborhood. I had a silver Suzuki Katana bike that my dad used to always say, No, don’t leave it in the front yard. Make sure you put it away, or one day you’ll come out and it wouldn’t be there. And of course, he was right. One day I came out and someone took it.

Robert Pease (co-host)

But he held onto those fond memories of bike rides as a kid.

Gene

There’s a long road named James Street in our town that was one of those roads that goes into all the towns in your area. And we would go on long bike rides. And so I remember that being a big part of my childhood, going on family bike rides with my dad.

Valerie Wencis (co-host)

Then about five years ago, right when his Dad contracted diabetes, Gene had a cycling epiphany.

Gene

I was just sitting on my couch one day in August. I turned on the TV and the coverage for the Pan Mass Challenge was on, like the news coverage. And I saw thousands of people slogging it out through the rain. And I said, you know what? That’s for me.

Valerie Wencis (co-host)

Similar to the Tour De Cure rides for diabetes, the Pan Mass Challenge is a two day, 200-mile bike ride to raise money for cancer. And training for both of these rides helped shift Gene’s cycling into high gear. He’s now completed four Pan Mass Challenges and a Tour De Cure.

Robert Pease (co-host)

Throughout his athletic career, football and basketball growing up, track in college, Gene’s dad has always been his greatest cheerleader.

Gene

My dad has been just an incredible support for me for my entire life in all of the ways that you could support someone. I think particularly in my athletic endeavors. I mean, I never wanted or needed for an opportunity to join a league or to have a class or to have a lesson or to have any equipment that I needed. I always had basketball shoes and receiver gloves for football.

Valerie Wencis (co-host)

And now that Gene’s cycling, his Dad again provided some crucial support.

Gene

And so when I bought my bike, my dad bought me carbon wheels which are lighter. And when you’re trying to pull 300 pounds up a hill, every bit of weight you can take off the bike matters. And so the whole time I’ve been riding, I’ve had these super durable, super light racing wheels that my dad got for me.

Valerie Wencis (co-host)

As a dad himself, Gene has also purchased bikes for his own daughter. He’s trying to pass along that tradition of the family bike ride.

Gene

Right now I outsmarted myself with her becoming a cyclist a bit, because she’s very tall for her age, and she outgrew her first bike. And so we got her her second bike and I was like, you know what? Rather than getting her the second bike that she’ll outgrow, let’s get her – cuz she’s tall enough for the third bike – the one that will have the hand brakes.

Robert Pease (co-host)

And that’s pretty much like parenting right there, doesn’t always go as planned.

Gene

And she had a little bit of a crash. And so she did not ride the bike at all the summer, not even once, she did no bike riding, which to me was a major setback.

Robert Pease (co-host)

So one family cycling project is on hold. But not Gene’s cycling, which has now gone year round. Two years ago he purchased a Peloton for the colder months, the rainy days, the busier times he cannot get outside for a ride.

Gene

So before I had the Peloton, you train really hard for cycling spring, summer, fall, and then in the wintertime, you kind of become less active. You know, having the Peloton has really allowed me to remain active and to work out before I go to work, or sometimes I’m watching football while doing a ride.

Valerie Wencis (co-host)

Over the years of cycling more regularly and watching his diet, this effort has begun to add up to an important reduction.

Gene

One of the reasons that I’m so passionate about cycling is, it is a hobby, it is a pursuit. But the training for the Pan Mass challenge and the Tour de Cure and other cycling events has actually enabled me to make some progress. And so in my last couple of annual physicals, my A1C has been trending in the correct direction, which is down.

Robert Pease (co-host)

We asked Dr Riddell: how unusual is it to make this kind of progress? And does this mean Gene has cured his prediabetic condition?

Dr. Michael Riddell

No, well you can definitely improve your body composition and your blood sugar levels and insulin sensitivity. And in the back of my mind, I don’t like to use the word cure because the person’s probably always at heightened risk. I think that they need to keep working at it. Because as we age, the incidence of developing prediabetes tends to go up anyway. And so I think you’re in remission from pre-diabetes. But I tend not to use the term cured, but I’m not offended if they use the word cured. I think that’s good news.

Valerie Wencis (co-host)

We’ll hear more about Gene’s odyssey in a future episode, and see how he’s doing maintaining and deepening that progress through diet and exercise. It’s a constant challenge, though one with huge rewards.

Robert Pease (co-host)

And Gene would like to see those rewards shared as broadly as possible. While at the Tour de Cure event, he spoke about the many students and families from the city school districts he administers not being able to participate in these and other charity rides with relatively high fundraising minimums. And yet these communities have really high rates of diabetes and pre-diabetes.

Gene

Whenever I’m at an event, I always try to think about who’s not here and who’s not represented. And so one thing now that’s my first year doing it, one thing I’ll do next year is try to share this opportunity with so many of the people I know who are cyclists in the city of Boston, in communities of color, Roxbury, Dorchester, Mattapan, who may not have had either the awareness or the resources get out here. I think there are a lot of people who are untapped.

Valerie Wencis (co-host)

We’ll check back in with Gene periodically on his own body odyssey, his training for next year’s Pan Mass challenge and Tour de Cure rides, and his efforts to involve other participants of color in active lifestyle events to raise money while instilling really beneficial habits.

Robert Pease (co-host)

I hear my Peloton calling to me, Valerie. Many thanks to Gene for sharing this inspiring odyssey with us. And thanks too to Drs. Colberg and Riddell for their expert insights. There are links to their bio pages and research in our show notes. Next up on My Body Odyssey, a truly remarkable story about an adaptive para-rower we met at the Head of the Charles Regatta.

Ron

The riggers weren’t attached right. They fell off, the boat got unbalanced, and the next thing I know, I’m under the water. I know what you’re thinking. A guy survives a head on crash with an SUV only to drown while giving rowing a shot.

Valerie Wencis (co-host)

Ron is an incredible example of courage and perseverance in the relatively new, still developing adaptive sport, para-rowing.

Robert Pease (co-host)

We hope you’ll join us for that episode, share My Body Odyssey with friends and family, and review us on Apple Subscriptions. My Body Odyssey is a Fluent Knowledge production. Original music by Ryan Adair Rooney.