Richard Fink was an All-High first baseman who weighed about 165 pounds when he played for the Bennett High School baseball team during the mid-1970s. He spent the 1980s and 90s playing Muni and suburban hardball with teams based near his Getzville home, as well as pickup basketball up to three times a week.

Im very competitive, he said.

Fink, 62, has worked the last three decades as a legal process server. Over the years, he spent a growing amount of time behind a desk or the wheel of a car. He ate lots of food on the go and enjoyed his share of the standard Buffalo diet: breakfast sandwiches, chicken wings and pizza.

The nearly 6-foot-tall Fink weighed 215 pounds when a case of pneumonia knocked him off his feet for two months early last year. He packed on another 15 pounds as he recovered.

Meanwhile, his blood sugar level crept into the diabetes range.

Ive played sports my whole life, so when youre diagnosed with diabetes its a shock, he said.

[BELOW: Diabetes ABCs, key prediabetes and diabetes test levels]

Fink was not at all comfortable joining the legion of 115 million Americans roughly one in three with diabetes or prediabetes. His primary care doctor put him on the oral medication Metformin and helped him understand the dangers unaddressed high blood sugar levels can bring: poor circulation that boosts the risk of blindness and kidney failure, heart attack, stroke and limb amputation.

Fink was floored.

If scientists tell you that you can go blind looking at the sun during an eclipse, you dont look. Its an immediate reaction, he said. But if it comes down to eating or other choices, its OK, because nothing happens immediately to you. But then, 20 years later, that accumulation of poor eating habits and behavior, it catches up with you. The bill comes due.

Fink decided to beat back diabetes. Heres how.

Start with a plan

Richard Fink, left, pledged to amp up his weekly workout regimen and change his diet after he was diagnosed with diabetes. (Robert Kirkham/Buffalo News)

Fink started his Type 2 diabetic journey last spring after lab tests showed his fasting blood sugar level at 338 milligrams per deciliter, more than three times the normal level. His A1C reading an average blood sugar percentage over two to three months stood at 7.2, also in the diabetes range.

The best thing someone can do when they get diagnosed with diabetes or prediabetes is to lose weight, he said. Its the essential key to ridding yourself of diabetes.

[RELATED: Type 1 diabetic from WNY touts little-used inhalable insulin]

Fink had long been interested in the training regimens of top athletes, even though he didnt always follow them himself, so he started from a place he understood: He needed to burn off more calories than he consumed.

Research shows that losing 15 percent of your body weight can lower the risk of Type 2 diabetes by more than 50 percent, according to the American Diabetes Association.

That kind of weight loss needed to start with a new mental approach, Fink reasoned. He started to make better, more educated health and fitness choices going forward every day and not get too discouraged if he slipped up occasionally.

The problem most people have is they want instant gratification, he said. You dont get out of shape overnight. You dont get in shape overnight. Its a process.

Nutrition is key

A Mediterranean diet including plenty of chicken and fish has been part of Richard Fink's nutrition plan. (Robert Kirkham/Buffalo News)

Diet and exercise has to be part of any diabetic regime, no matter what, said Dr. Howard Lippes, a Williamsville endocrinologist.

Fink was determined to add more exercise to his weekly regimen. For him, the remnants of his past made this the easier part. The more important thing to remember is that you cannot out-train a bad diet, he said.

He pretty much knew how to eat right, but the new numbers in his life underlined that he didnt make the best choices often enough. He turned decidedly to a Mediterranean diet. He gave up cereal, white breads and other processed foods made with simple carbohydrates and added sugars. Simple carbs as opposed to their more complex kin, found mostly in vegetables raise blood sugar levels, which promote body inflammation that fuels many chronic diseases, including diabetes, the seventh leading cause of death in the U.S.

Fink fed his better habits with information gleaned from books, magazines and (shameful plug intended) WNY Refresh. He tends to eat eggs for breakfast, a light, chicken-based meal for lunch and dinners rich in chicken, fish, fruits and vegetables. He drinks plenty of water. He has never smoked anything and doesnt drink alcohol, which in excess also promotes disease.

Do I still love wings? Absolutely, he said. Do I still have them once in a while? Sure, but I have changed to a lot of healthy eating. You need to have chicken and fish and salads, and be careful on dressings and toppings. Youve got to read labels, too. I never thought I needed to. The more informed you can become, the better.

Exercise counts

Each member who takes group classes at Orangetheory wears a heart rate monitor to let them know when they approach their maximum heart rate. (Robert Kirkham/Buffalo News)

There are plenty of days I dont want to work out, Fink said, but those are the days that are most important. You have to force yourself to do what you need to do to burn calories, and drive by places where you shouldnt be eating.

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Fink turned to Orangetheory in Amherst to burn calories. He takes a late afternoon class five to six days a week in which workouts vary, keeping things interesting and targeting different muscle groups. Trainers help guide his fitness and exercise form during hourlong workouts split between challenging treadmill work and circuit training that includes rowing machines, free weights and TRX resistance bands. The workouts focus on splat points one point for every minute in the Orange zone, 84 to 90 percent of your maximum heart rate. You want you to get 12 to 20 points per session to develop an afterburn that keeps you shedding calories for a day or so after your workout.

When I go for my workout, I burn 800, 900 calories, Fink said, so technically, after my workout, I havent eaten because Ive burned off breakfast and lunch.

Your heart is a muscle that Fink compares to a Lamborghini. If you walk every day, thats good, but its like driving that car at 25 miles an hour, he said. Youve got to open that up, raise that heart rate every once in a while, to make sure youre working it.

Its important to check with your doctor before starting an exercise routine.

A new way of life

Fink has learned since last spring that hard, consistent work can pay off. Being healthy is a second job, he said.

He has lost 30 pounds since last year and his A1C level is down to 5.4 below the prediabetic and diabetic range. He is taking a quarter the dose of his original diabetes prescription and looks to soon get off it completely. He aims to stay this way.

You cant say, I got rid of it, so I can eat doughnuts again. You dont want to do that, he said. You can blow a whole workout with foods like that. You have to combine exercise with diet. People say they cant lose weight. Dont say you cant. Say youre not going to make the effort. If youre not making the effort, who are you cheating?

The ABCs of diabetes

Type 1 diabetes:Normally diagnosed in children and young adults. The body does not produce insulin, a hormone needed to convert sugar, starches and other food into energy the bodys cells need for daily life. Only 5 percent of people with diabetes have this form of the disease, which is treated with insulin therapy.

Type2diabetes:Almost 30 million Americans have Type 1 or 2 diabetes; Type 2 is by far the most common form. The body does not produce enough insulin, or the cells ignore the insulin, and glucose builds up in the bloodstream instead.

It is more common as a percentage among African-Americans, Latinos, Native Americans and Asian Americans. Roughly one in four Americans age 65 and older has diabetes.

More than 80 percent of those with Type 2 diabetes are overweight.

Complications, which can vary widely and by degree, include glaucoma, cataracts and other eye problems; numbness in the feet; skin infections and skin disorders; hearing loss; depression; and high blood pressure, which raises your risk for heart attack, stroke and kidney disease.

High blood sugar can overwork the kidneys, causing them to stop working properly. When diagnosed early, kidney disease can be slowed with treatment; when diagnosed later, kidney failure usually results.

Prediabetes:An estimated 86 million Americans have prediabetes. Before people develop Type 2 diabetes, they almost always have prediabetes, or blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.

Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes.

Key tests

A1C: Measures the average blood sugar (glucose) level percentage over 2-3 months.

Results of A1C:

Normal:less than 5.7 percent

Prediabetes:5.7 to 6.4 percent

Diabetes:6.5 percent or higher

Fasting Plasma Glucose: Levels of milligrams per deciliter of blood glucose after fasting at least 8 hours.

Results of FPG:

Normal:less than 100 mg/dl

Prediabetes:100-125 mg/dl

Diabetes:126 mg/dl or higher

Oral Glucose Tolerance Test: Levels of milligrams per deciliter before and 2 hours after a sweet drink; most often used to test for diabetes during pregnancy.

Results of OCTT:

Normal:less than 140 mg/dl

Prediabetes:140-129 mg/dl

Diabetes:200 mg/dl or higher

Prevention and treatment

Exercise and a healthy diet are key to preventing prediabetes and diabetes, as well as better managing them. (Robert Kirkham/Buffalo News)

Regular exercise and a healthy diet void of processed foods can help.

Smoking, high blood pressure, abnormal blood cholesterol levels, being overweight and being sedentary can worsen diabetes.

Medications and dialysis are treatments that may be required.

Sources: American Diabetes Association (diabetes.org), Seneca Nation of Indians Diabetes Foundation

Resourcesfrom the Buffalo & Erie County Public Libraries

What to Expect When You Have Diabetes: 170 tips for living well with diabetes, American Diabetes Association

Whole Cooking & Nutrition: An everyday superfoods approach to planning, cooking, and eating with diabetes, Katie Cavuto

Your Type 2 Diabetes Action Plan: Tips, techniques, and practical advice for living well with diabetes, American Diabetes Association

The Diabetes Reset: Avoid it, control it, even reverse it a doctors scientific program, George King

Diabetes Without Drugs: The 5-step program to control blood sugar naturally and prevent diabetes complications, Suzy Cohen

For more information, visit buffalolib.org.

email: refresh@buffnews.com

Twitter: @BNrefresh, @ScottBScanlon

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Floored by diabetes diagnosis, Richard Fink fought back - Buffalo News

The American Diabetes Association Education Recognition Certificate for a quality diabetes self-management education program was recently awarded to the Magnolia Regional Medical Center program.

ADSA believes that this program offers high-quality education that is an essential component of effective diabetes treatment.

The Associations Education Recognition Certificate assures that educational programs meet the National Standards for Diabetes Self-Management Education Programs. These Standards were developed and tested under the auspices of the National Diabetes Advisory Board in 1983 and were revised by the diabetes community in 1994, 2000, 2007 and 2012.

Programs apply for recognition voluntarily. Programs that achieve recognition status have a staff of knowledgeable health professionals who can provide participants with comprehensive information about diabetes management.

The process gives professionals a national standard by which to measure the quality of services they provide, said Rex Jones, CEO. And, of course, it assures the consumer that he or she will likely receive high-quality service.

Education Recognition status is verified by an official certificate from ADA and is awarded for four years.

According to the American Diabetes Association, there are 29.1 million people or 9.3% of the population in the United States who have diabetes. While an estimated 21 million have been diagnosed, unfortunately, 8.1 million people are not aware that they have this disease. Each day more than 3,900 people are diagnosed with diabetes.

Many will first learn that they have diabetes when they are treated for one of its life-threatening complications heart disease and stroke, kidney disease, blindness, and nerve disease and amputation.

About 1.4 million new cases of diabetes were diagnosed in people aged 20 years or older in 2014 in the U.S. Diabetes contributed to 234,051 deaths in 2010, making it the seventh leading cause of death in the U.S. Overall, the risk for death among people with diabetes is 50% greater than that of people of similar age but without diabetes.

The American Diabetes Association is the nations leading non-profit health organization supporting diabetes research, advocacy and information for health professionals, patients and the public. Founded in 1940, the association conducts programs in communities nationwide.

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MRMC's diabetes education program receives certification - Magnoliareporter

NDTV

Designing better drugs to treat type 2 diabetes Science Daily "Type two diabetes is characterised by resistance to insulin with subsequent high blood sugar which leads to serious disease. It is usually associated with poor lifestyle factors such as diet and lack of exercise," says lead researcher Dr John Bruning ... Soon, Anti-Diabetes Drugs to Replace Painful Insulin JabsNDTV New diabetes drug may soon replace insulin jabsDeccan Chronicle Suffering from diabetes? Here's some good news for youEconomic Times Diabetes.co.uk -Zee News all 12 news articles »

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Designing better drugs to treat type 2 diabetes - Science Daily

Eric Fenar is a Type 1 diabetic whoexercises regularly,rigorously measures his blood sugar levels and takes othersteps to stayhealthy.

Still, he says,"In life, it's tough to eat tofu and salad and grilled chicken every day."

He likes Asian food, pizza and beer too much for that.

This is why Fenar has become one of the biggest volunteer pitchmen in the country for an inhalable insulin drug called Afrezza a drug that has helped the 34-year-old Buffalo public school teacher reach the most stable blood glucose levels he's had since he was diagnosed at age 10.

"There is a little bit of a learning curve," he said, "but now I have the power to fight those high blood sugars. Life is much more flexible."

Fenar discovered Afrezza during one of his routine online searches about better diabetes management. He testified at a 2014 federal Food and Drug Administration hearing to tout the promise of Afrezza for those like himself before he'd even tried the drug. He met Al Mann, the creator, before the billionaire businessman died in February 2016.

[RELATED STORY: Floored by diabetes diagnosis, Richard Fink fought back]

Fenar grew up in Lancaster. He remembers the weekend he was diagnosed with Type 1 diabetes, because he watched on a hospital television set on Oct. 23, 1993, as Joe Carter hit a home run to help the Toronto Blue Jays win the World Series.

His diagnosis meant that his body produced no insulin to help him break down food. It also meant a lifetime of insulin injections and great sacrifices as he kept vigilant watch on his blood sugar levels or so it seemed at the time.

"I want people to be aware of this option," Eric Fenar says. "This is what I needed: a faster insulin."

"My family has always been up to date on the latest technologies," he said. "I was up to date on the shots for two years and mom read about the insulin pump. Back then it was only for people 18 and over. At this point, I was about 12."

His mother, Susan, a nurse, convinced doctors and health insurers that Fenar was capable of using a pump to monitor his glucose levels and give himself insulin without dispensing a potentially fatal overdose.

Years later, he started to use a Dexcom, a Bluetooth-compatible device that reads blood sugar without the need to do a finger-prick blood test. This allowed him to use his pump, or an injection, to push the correct amount of insulin into his bloodstream.

The challenge, Fenar said, is the lag time that comes with injectable insulin. It can take 45 minutes to an hour for the effect to take hold causing damage from high blood sugar and running the risk of an insulin crash or overflow, particularly an hour or so before or after meals.

"The thing that got me is Afrezza starts to work in 12 to 15 minutes," he said.

Dr. Howard Lippes, a Williamsville endocrinologist, assistant clinical professor with the University at Buffalo medical school and owner of R&B Medical Group, prescribes the inhalable drug to about 15 to 20 percent of his Type 1 adult diabetic patients.

Some use it regularly, others intermittently "to correct high glucose," he said. "There are pros and cons. It's not better. It's different."

Lippes doesn't count Afrezza's inhalability as a big advantage, "given the ease of today's insulin pen devices, which are simple and painless," he said. But he and patients who use it appreciate the speed in which it can control blood sugar levels.

For example, those like Fenar who enjoy pizza. When someone without diabetes eats pizza, or other food or drink loaded with carbs, the pancreas starts making insulin right away to compensate for the spike in blood sugar, which can cause inflammation and damage the cardiovascular system.

"If you're diabetic and eat a meal, you've got to give the insulin a running start if you want to catch the blood sugar before it goes up," Lippes said. "The timing of the meal can be a bit daunting. The Afrezza works really quickly, so that is an advantage for some patients."

It also has a shorter "tail" than injectable insulins, leaving the bloodstream faster so the danger of a lingering low blood sugar reaction diminishes, the doctor said.

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Lippes prescribes Afrezza almost exclusively for those with Type 1 diabetes. It costs about the same as injectable insulin and is covered by most health insurance plans, he said.

Those with a cough or cold may not want to use it, Lippes said, and it is not recommended for those with asthma or chronic lung diseases like COPD. Its use is discouraged by those who smoke, "not that any diabetic should do that," Lippes said.

A small percentage of patients who try Afrezza get a throat irritation or cough, though the majority of patients tolerate it well.

Despite its advantages, the inhalable drug has yet to reach a critical mass in the diabetes drug industry.

Creator Mann ran 17 companies that helped improve pacemakers, cochlear implantsand insulin pumps. He put $1 billion of his own money into Afrezza before he died, at age 90, and also was at work on developing an artificial retina.

Lippes blamed lagging Afrezza sales on the relatively small size of the drug-making company, MannKind, as well as the first inhalable drug, Exubera, which Pfizer introduced more than a decade ago, then pulled from the market in 2007. In that case, the inhalation device was so big, it couldn't fit into a purse and looked like something you'd use to smoke illegal drugs. It proved too cumbersome for most who tried it, Lippes said.

He described the Afrezza inhaler as "a little whistle device," which dispenses powdered insulin in 4-, 8- and 12-unit doses.

The Afrezza inhaler is a whistlelike device, which dispenses powdered insulin in 4-, 8- and 12-unit doses.

Fenar needs a basal insulin injection once a day, to keep his sugar levels stable while he sleeps. Otherwise, he has found reliability in the drug and delivery method he advocates.

"With Afrezza, I was able to get off my insulin pump," he said. "I used to carry what I called a diabetic man purse," with extra pump supplies and extra insulin. "Now, when I leave the house, I have a tenth of what I used to carry.I'm not connected to anything. And for my insulin needs, I take Afrezza.

"I want people to be aware of this option. This is what I needed: a faster insulin."

For Lippes, the drug represents one of several exciting new changes in diabetes treatment.

The next, he said, is the sensor augmented insulin pump. Medtronics Corp. which recently hit the market with its variety, the 670G Pump refers to it as "the artificial pancreas."

"It's not quite there yet," Lippes said, "but we're on the threshold of big changes with these new glucose sensor devices that can tell the insulin pump what to do in real time. I have patients lined up to get it."

Read more:
Buffalo teacher a key advocate in breakthrough diabetes drug - Buffalo News

All signs seem to suggest Apple is gearing up to release a special blood sugar trackerfor the Apple Watch.

As it turns out, none other than CEO Tim Cook has been spotted wearing what appeared to be an Apple Watch-connected glucose tracker in the vicinity of the company campus, CNBC reports.

Unfortunately, details remain pretty scarce as of now with the exception that the new wearable module is directly connected to the Watch.

Assuming the Big A manages to fine-tune the rumored blood sugar tracker, the technology could become a must-have for millions of people suffering from or at risk of getting diabetes.

Apple was first rumored to be working on a dedicated diabetes wearable back in April, when CNBC reported the company has assembled a secret super-team of bioengineers to craft a solution for tracking blood sugar levels with the Watch.

Speaking at the University of Glasgow earlier in February, Cook said he had been wearing a continuous glucose monitor for a few weeks but stopped short of making any significant revelation about the gadget.

One thing the Apple chief clarified though is that the device would also make it easier for people to responsibly monitor their blood sugar levels and avoid health complications.

Its mentally anguishing to stick yourself many times a day to check your blood sugar, he commented. There is lots of hope out there that if someone has constant knowledge of what theyre eating, they can instantly know what causes the response and that they can adjust well before they become diabetic.

on CNBC

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Tim Cook is reportedly testing Apple Watch-connected diabetes tracker - TNW