Profile: Ernesto Acosta started an exercise and medication regimen

It was the specter of bariatric surgery that motivated Ernesto Acosta to change his ways. Acosta, 54, was diagnosed with Type 2 diabetes in 1998, but he didn’t pay attention to it for many years.

Initially depressed and in denial, the Ventura County prosecutor didn’t follow his prescriptions or his doctor’s advice and lied to her about what he ate. “I would say I had a little bit of cereal,” he recalled, even though he actually had chowed down on ham and cheese sandwiches and Milano cookies for breakfast.

His numbers reflected his poor choices — his fasting blood sugar in the morning would be a whopping 300, his blood pressure hit 140/90 and the small-framed Cuban American weighed 230 pounds.

When he attended a seminar about lap-band surgery, a switch flipped in his mind. “The surgeon made statements that really upset me, like, ‘Exercise and diet are not going to do it for you — only I can save you with the lap-band,’ ” Acosta recalled. “I ran from that real fast.”

Acosta, who had run 10K races and cycled 100-mile rides in his 30s, was determined to get back into shape on his own. He pulled his Italian road bike out of the garage and began with 10-mile rides. During lunch breaks, he rode along Pacific Coast Highway.

At the same time, his doctor added the injectable diabetes drug Victoza to his regimen, which already included insulin and metformin. Victoza also has an appetite-suppressing side effect. Soon the pounds and his blood sugar began to come down.

As he increased his rides to 30 — and now 60 — miles, he stopped craving junk food as much as he used to. Now his highest blood sugar level is 90 — even after his favorite dinner of “black beans, rice, yucca, plantains, the whole works,” he says. He’s lowered his daily insulin from 140 units to 30, his blood pressure is 117/72 and he’s dropped 6 inches from his waist and 40 pounds.

“Sometimes you get a craving to pig out on Mexican food, but I’ve worked too hard to feel good to throw it away,” he says. “Life feels worth living again.”

—Kendall Powell