By Juliana Ronn, First Mile Care Director of Operations

Mike Kowis wrapped up the year-long First Mile Care Diabetes Prevention Program (DPP) in September. He is happy to share his First Mile Care success story with other people battling against  prediabetes. Below is an interview with him about the results he’s experienced with the DPP and his tips for leading a healthier lifestyle.

  1. Thanks for sharing your story, Mike. Could you tell us how the First Mile Care Diabetes Prevention Program has changed your life?
  • I feel more energetic overall, because I make an effort to be active every single day. I’m closing in on 300 days straight of surpassing my daily goal of 10,000 steps.
  • I lost about 10 pounds within the first couple of months of the program. That’s not a lot, but I’ve been able to keep it off for over a year now and am confident I won’t gain it back. Even if the weight starts to come back in the future, I now have the tools needed to take it off again. 
  • My waist is a little smaller and my abdominal area is flatter, to the point that I now have to wear a belt with my trousers and shorts to keep them from slipping! Guess it’s time to go shopping.
  • The blood work from my last medical checkup showed definite improvement, especially with lower triglycerides (fat) in my blood and a slightly lower cholesterol level.


  1. Tell us a little about yourself.  Did you have an active or sedentary lifestyle before joining First Mile Care?

I’m a 51-year-old senior tax attorney at Entergy Services, LLC. In other words, I’m a tax geek and spend a lot of time working on the computer. I live with my wife (our kids are grown) in Conroe, Texas, which is approximately 40 miles north of Houston. In my spare time, I’ve written several nonfiction books on various topics including tax trivia and have been an adjunct faculty member at Lone Star College-Montgomery for 20 years. So, I’m a pretty busy guy and have limited time for fitness. However, I’ve tried to stay fit through yard work and working out in my company’s gym two or three days a week. But I didn’t exercise as regularly and as intentionally as I do now.


  1. What has been your experience with diet and fitness programs?

I was fairly successful with the low-carb South Beach Diet several years ago. My triglycerides and cholesterol levels improved, and I was able to reduce my cholesterol medication to the lowest daily dose. But I like chips, pizza, and bread,  and at some point I just got tired of the self-denial. I stuck with it for three years, but couldn’t make a forever change. I slowly introduced a few more carbs into my diet, and then a few more, and eventually I wasn’t following the program anymore. And so the weight came back.

I had a Fitbit health monitoring device for a couple of years before starting with First Mile Care. Since I’m a numbers geek, I was good about observing my daily steps. Before this program, I typically walked 10,000 or more steps a day for three or four days each week, but I didn’t think about it in terms of burning calories. And I occasionally participated in fitness challenges at my day job where I walked 10,000 steps daily for a certain number of weeks to win a prize. I would commit to that activity for the period of the competition, and then go back to my occasional walks. It just wasn’t a priority for me to maintain the activity and make sustainable changes.


  1. How did you hear about First Mile Care as a treatment option for your prediabetes?

I was invited to join the program by Dr. John Walker of Highland Woods Health in The Woodlands, Texas (part of Privia Medical Group). I have a history of diabetes in my family and watched my grandmother prick her finger often to test her blood sugar levels. At that time, I recall thinking that I didn’t want to go through that if there was any way to avoid it. Over the years, I have tried to stay healthy and did not consider myself at high risk for developing the disease. When I learned I was considered in the prediabetes stage, it was a real wake-up call. My current physician, Dr. Christopher Prihoda, was quite pleased with my results after a few months of participating in the First Mile Care DPP.

  1. What do you like most about the First Mile Care program? Why do you think it has worked for you?

I realized there were really only two things that my coach asked me to do. One was to measure my steps, which I was already doing through my Fitbit. And the second one was to use the MyFitnessPal app or something similar to track my calories. So I downloaded the free app and linked it up with my Fitbit. Then everything was right there on my phone and incredibly easy to track. The tools have made me more mindful of what I eat and how much I exercise.

One of the things that attracted me to this program is that there is no “bad” food. As my First Mile Care coach, Sandra Huskey, explained, the program advocates balance and moderation. I have to be mindful of what I eat and if I go over my daily calorie target one day, I simply compensate for it the next — but I can eat what I want as long as I do enough exercise to burn off my calorie intake. That makes it much easier to follow the program. I feel confident I’ll be able to stick with it, versus the South Beach Diet where I had to swear off foods that I loved because of the carbohydrates. That’s really hard to do for the long term.

I found the First Mile Care program empowering because I could instantly see the effects of my food choices (which I entered in the app) and the value of my steps (which are automatically counted on my Fitbit). At any point in the day, I could check my calorie intake and see how much I had left of my daily calorie allotment. For example, the two tablespoons of peanut butter that I spread on toast every morning is 200 calories. That knowledge hasn’t made me stop eating peanut butter, but I am more careful. Maybe I only have one piece of toast with peanut butter instead of two. And if I want to eat more, all I do is take an extra walk around the block or shoot some hoops on the basketball court to burn off those extra calories. It’s within my control to change those numbers so I don’t have to feel guilty about having that extra dessert. That is probably my favorite aspect of the DPP — feeling in control.

  1. First Mile Care emphasizes in-person, neighborhood-based DPP groups. Did you find this helpful?

I didn’t know the other people in my group, and yet I could relate to them. It was reassuring to know that we were all based in the same area, used the same doctors, ate at the same Tex-Mex restaurants, and shopped at the same supermarkets. It built a sense of camaraderie just knowing that we were all local and facing the same health challenges together.

I was also inspired by my group members. All of them were older than me and retired. When I saw how committed they were to making sustainable lifestyle changes and how much weight they were losing, it made me think, hey, if they can do it, I can too.  I had no excuses because I was younger and generally healthier than the other participants. It was motivating to see those folks working so hard and making real gains.

One of the most rewarding parts of the program, besides feeling better and losing weight, was getting together with Coach Sandra and the other participants and telling them about meeting my goal of walking 10,000 steps every single day. My wife is tired of hearing me talk about it, so it was great to join the meeting and get a pat on the back from the group. It also felt great to be encouraged by people who sincerely cared about my success and were happy for me. I miss that benefit now that the program has finished. However,  I’ve been able to get  “attaboys” from some of my work colleagues  who see me occasionally post my daily step updates on our employee social network.


  1. What role has your coach played in your success?

I viewed our group coach, Sandra Huskey, as a personal life coach rather than just a group facilitator or trainer. From day one, Coach Sandra took a sincere interest in everybody. She didn’t tell us what to do, but helped each person to develop our own action plans. She’d ask, “Are you going to start walking more steps than you did before, or more consistently? Are you going to find another form of exercise or maybe start playing basketball?” She would encourage us to improve our activity levels and offer helpful advice. Sometimes it’s just common sense, but it really helps to have someone talk to you about it and encourage you to be more mindful. I liked getting her perspective on my progress and knew she had my best interests at heart.

When you see your doctor once or twice a year, you expect him or her to tell you to lose a few pounds or to be more active. Even if you tell them that you’ve been active and have lost weight, there’s always room for improvement. But with Coach Sandra, she was always excited at even small improvements, and was encouraging even if you plateaued. She emphasized that progress is incremental. She asked me to keep in touch once I’d finished the program to let her know when I’d hit my activity milestones. 

  1. What surprising thing did you learn about yourself in the program?

I learned from Coach Sandra to be mindful of habits. For example, when I sit down in the evenings to watch TV, I usually have a snack like popcorn or ice cream. After our discussion of triggers and habits in a First Mile Care session, I started to think about why I eat in the evenings. Sometimes you eat due to emotions, but sometimes it’s just boredom.  I realized that I eat at night because it’s just what I do as a routine. It’s not always because I’m hungry. It’s usually just a habit, and it’s triggered by turning on my favorite talk show. So I have learned to stop myself from opening the refrigerator or cupboard and instead ask myself, am I really hungry? Maybe I don’t need that popcorn or ice cream. If I am hungry, then I consider the calories of my available food choices before deciding which snack to eat. And so that was something surprising that I learned out of the program that has contributed to my overall health.


  1. What kind of changes have you made as a result of the First Mile Care DPP?

First Mile Care has counseled me on how to develop good habits that I can control. I’ve learned how to use information from digital tools, like my Fitbit and the MyFitnessPal app, so I can determine the activity level I need to reach to burn off whatever I’ve eaten. I’ve developed a personal fitness and diet plan that is easy to adjust and maintain. There’s so much information out there; First Mile Care helped me see how to combine it in a way that works best for me, without having to give up my favorite foods.

I’ve also learned to make substitutes. As I mentioned, I like to eat a snack in the evening while watching TV. After questioning myself why I’m craving it, and if I still want something salty and crunchy, I might substitute a raw carrot stick and sprinkle on a tiny amount of salt. I’m still getting that salty taste that I crave, but am also eating a healthy snack with vitamins instead of the empty calories in popcorn. It might sound weird to substitute carrots for popcorn, but it works for me!

The biggest thing for me, of course, has been working towards my goal of one year of over 10,000 steps per day. At first I only wanted to hit 100 days. Then I thought, why not go for 200 days. And now I’ve set 365 days as my goal. I’ve been able to do it so far, but even if I were to fall behind one day, I’m confident that I’ll just pick up the next day and start over. I like the way I feel now, and that is partly due to this steps commitment.

  1. Now that your year-long DPP course has finished, how are you sustaining the changes you’ve made?

I work out at home at least two or three times a week. During the early months of the COVID shutdown, I wasn’t exercising regularly and didn’t feel healthy. I wasn’t energetic, and my body wasn’t responsive and flexible. Since I joined the First Mile Care DPP and got back into a consistent activity routine, I feel great. I shoot baskets in my backyard even if it’s only for 20 minutes on hot days, to get in some extra steps. Santa brought me a weight bench and equipment for my garage, so I can exercise with weights two or three times a week as I used to do when I could use my company’s gym pre-COVID.

I’m totally committed to hitting more than 10,000 steps a day. It’s become such a habit now that even when I was travelling out of town for my daughter’s college graduation last May and checked into the hotel late at night, I went outside for a walk just before midnight to make sure I hit my daily goal. Tropical Storm Nicholas blew through and I still went outside for a daily walk. In the past, I’d never have considered walking in the rain to get exercise. Instead, I’d just sit inside and watch TV or work on the computer.  But since I started the First Mile Care program, I’m more mindful now of my activity level and have become committed to my daily steps. I now feel confident that I’ll stick to it, and I’m happy about that.

While I tracked my calorie intake for about six months, and found it easy to do this with the MyFitnessPal app, I no longer do this. During the summer, my wife and I took a vacation trip to Montana, and I stopped tracking during that time. I did get in a ton of walking in the national parks so didn’t see any ill effects. When I got back from vacation, I was busy with work and used that as an excuse not to log my food intake. But I have found that my weight only fluctuates up or down by a couple of pounds because I am keeping up my activity level and eating the same foods. At this point, I’m so accustomed to what I’m eating — a lot of the same foods in the same quantities —  that I have a pretty good idea of what the calories are when planning meals.  As Coach Sandra often said, the app is there on my phone should I ever need it. If I see my weight go up, I can easily start tracking again. 

First Mile Care taught me good habits that sustain my lifestyle changes. The program opened my eyes to different tools and practices for enabling a healthy lifestyle, and helped me discover things about myself that I could change. I’ve been able to combine my new knowledge and the tools with a growth mindset to create new habits that really work for me. I appreciate how the program, my coach, and my classmates helped me on my path to good health  — while allowing me to remain in control.

To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!