Bud and Gayle Nakano

First published June 2011

Bud and Gayle Nakano have been married for nearly 40 years. However, they have negotiated the needs of a constant companion throughout their entire marriage: diabetes.

As the decades have passed, the couple from Palo Alto, California, has adapted to the difficulties of diabetes and its complications. Today, they embrace a cultural diabetes niche in order to help support and improve the lives of those who share their struggle.

The Nakanos first learned what diabetes was when Bud, at age 28 in 1970, went to the doctor for an insurance checkup. This was just one month after he met his soon-to-be-wife, Gayle.

Bud’s glucose tolerance test led his doctor to believe that he needed to “walk more and see a dietician.” He was prescribed a new diet but “diabetes” was mentioned only casually. In fact, a year after his first diagnosis, having done what the doctor prescribed, Bud was given a clean bill of health, not knowing at the time that diabetes is a chronic illness.

However, an old football injury started acting up, and after a visit to an orthopedist, Bud was diagnosed with arthritis. He was encouraged to stop running and to commit to fewer athletic activities.

The Turning Point

The Nakanos attribute this lifestyle change as a major turning point in Bud’s health. Even further into middle age and less mobile, Bud went back to the doctor in 1989 for a sty on his eyelid, commonly found as a complication of diabetes and other chronic illnesses. It was then and there that Bud was re-diagnosed with diabetes.

“We started to make more lifestyle changes to accommodate Bud’s health based on recommendations doctors made in the 1980s and 90s after his ‘second’ diagnosis,” says Gayle.

The Nakanos’ first exposure to the American Diabetes Association was through their diabetes “Basics of Diabetes” support group in San José, led by a certified diabetes educator. The leader gave them practical ways to manage Bud’s illness and a safe place to discuss the emotional highs and lows that each family faces when dealing with diabetes.

“It gives you a sound foundation of Do’s and Don’ts, and a lot of information on problems you may encounter and how to handle them,” Bud explains.

Commitment to High-Risk Groups

The Association’s influence through the support groups started an almost three-decade long relationship between the Nakanos and the organization, especially in the local Bay area.

What attracted the Nakanos to stay with the Association is its commitment to focusing on how diabetes affects various high-risk groups. Ten percent of Asian Americans are affected by diabetes, over 95 percent of whom have type 2 diabetes. Despite having a lower body weight than Caucasians, diabetes affects Asians in the United States disproportionately.

The Nakanos’ concern is well founded, as Japanese Americans are more likely to have diabetes than native Japanese, suggesting that environmental factors, such as a Western diet high in fat and a lack of exercise, play a big part. Alternatively, since Japanese Americans have a higher prevalence of type 2 diabetes than their Caucasian counterparts, genetic factors most likely come into play as well.

Bud and Gayle look to Japanese-American diabetes scientist Wilfred Fujimoto, MD, for guidance on the status of type 1 and type 2 in their culture. Dr. Fujimoto was previously-funded by the Association and has been a long-time volunteer, especially on the west coast and Hawaii.

World-renowned for his work with diabetes in Asians and Pacific Islanders, Dr. Fujimoto is a recipient of the Kelly West Award and a member of the Asian Pacific American Diabetes Action Council.

According to Dr. Fujimoto, Japanese Americans have a greater tendency to store visceral (intraabdominal) fat than subcutaneous (under the skin) fat. Visceral adiposity (body fat) is associated with future insulin resistance, putting Japanese Americans at greater risk for developing diabetes.

“I felt that his research applied to me," says Bud. "The study ‘Wil’ does now in the U.S. focuses on the same gene pool as those who are native Japanese.”

Investing in Research

Due to the positive experiences they have had with the Association’s research expertise, Bud and Gayle decided to elevate their financial commitment. In 2010, Bud and Gayle became Pinnacle Society members, pledging a major-gift to the Research Foundation.

Funds like these are needed by the Association today to perform the necessary research to treat, prevent and one day cure diabetes.

Bud and Gayle have also decided to make a longterm investment in the Association. In late 2010, they chose to become members to the Association’s Summit Circle, the organization’s planned giving society. By leaving the organization in their will, the Nakanos will see to it that the Association will continue to work to improve lives for many more years to come.

As the Nakanos’ priorities evolve, so do the Association’s. Diabetes education and awareness in the Asian community have developed, as well. The Association recently established the Asian American, Native Hawaiian and Pacific Islander (AANHPI) Subcommittee in order to create an official AANHPI Program to support high-risk communities.

Meanwhile, the organization has generous longstanding donors like Bud and Gayle to thank for their gifts and their influence to encourage our collective diabetes knowledge—both scientific and cultural—to grow. With nearly a dozen diabetic complications to his name, Bud’s priority is to help people avoid the dangers of diabetes and live healthier lives.

“Now that we’re 70 years old, we have been looking to the future,” says Bud. “We have to do everything in our power now to make a difference in our own health and for others’, especially within our families and communities. This is important — you just have to do it.”