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Case Study
Rapid remission of chronic, progressive conditions and reducing polypharmacy by utilizing lifestyle therapy to target insulinemic lifestyle components

HIGHLIGHTS
•Lifestyle therapy rapidly provides complete remission of type 2 diabetes mellitus

•Lifestyle therapy eliminates risk of polypharmacy and reduces costs

•Targeting insulinemic lifestyle components reduces insulin resistance

•Complete remission of type 2 diabetes is possible using lifestyle therapy

•Failure to use lifestyle therapy may contribute to disease burden and cost of care

ABSTRACT
This case study provides evidence that homeostatic control in a patient with hyperglycemia and other metabolic abnormalities associated with insulin resistance can be rapidly restored utilizing lifestyle therapy. The patient, an overweight, 70-year-old, non-Hispanic white, male, had been medicated for hypertension, and Type 2 Diabetes Mellitus for 12-years. From baseline during 21-months of follow-up, HbA1c decreased from 6.6% to 5.4%, mean fasting glucose decreased from 125 mg/dL to 94 mg/dL, blood pressure decreased from 130/85 mmHg to 100/64 mmHg, estimated Glomerular Filtration Rate increased from 50 ml/min/1.73m² to 58 ml/min/1.73m², waist circumference decreased from 118.8 cm to 90.8 cm, and liver function improved with aspartate transaminase decreasing from 44 IU/L to 17 IU/L and alanine transaminase decreasing from 34 IU/L to 21 IU/L. Each of these metabolic corrections were observed while eliminating respective disease specific medications. These metabolic improvements were achieved using primary recommended lifestyle therapy specifically targeting known insulinemic lifestyle components. This case study shows the utilization of primary recommended, on-going lifestyle therapy targeting insulinemic lifestyle components can rapidly improve markers of insulin resistance and normalize abnormal laboratory values, while eliminating the risk of polypharmacy and the direct costs of medication.