Reversal of type 2 diabetes mellitus in an obese man: Role of dietary modification and physical activity

Abstract

Reversal of Type 2 diabetes mellitus (Type 2 DM) in obese patients with short-term history of diabetes has been seen. However, achieving such reversal in patients with long-term history of diabetes and maintaining long-term metabolic control with dietary modification and physical activity (PA) has not been documented. The aim of this paper is to report a novel case of an obese man (BMI = 43.6 kg/m²) in his fifties with a 20-year history of Type 2 DM, dyslipidemia and hypertension treated with medication who was able to reverse these disorders and stop all medications after being exposed to a very low-calorie diet (VLCD) for 16 weeks. With this treatment he was able to reduce his weight by 15.3% (BMI = 37.0 kg/m²) and his laboratory values were normal including a glycated hemoglobin (HbA1c) of 6.0%. Continuing with the combination of low-calorie diets (LCDs) and a supervised moderate-intensity exercise program for a period of 10 months, he reduced his weight by another 12.7% (BMI = 31.4 kg/m²) and his laboratory values remained normal. At > 3 years of follow-up with the combination of weight-maintenance diet, supervised moderate-intensity exercise program and counselling his BMI is 32.9 kg/m² and he maintains adequate metabolic control including an HbA1c that stays ≤ 6.5%. Although future clinical research is needed to confirm these findings, this case-report demonstrates that dietary modification and PA can reverse Type 2 DM and provide long-term protective effects against obesity-associated disorders in patients with a long-history of Type 2 DM.