Abstract
Type 2 diabetes mellitus (T2DM) in adulthood is strongly related to weight gain and excessive accumulation of pancreatic and hepatic fat. We present a case of a 48-year-old man with diabetes who presented two years prior with poorly controlled T2DM diagnosed more than three years before presentation. He had severe hypertension and marked dyslipidemia. He underwent a complete remission of his diabetes after nonintentionally losing 18 kg (his original weight: 58 kg). The patient had excellent euglycemic measures on no treatment at all for the last two years with healthy blood pressure and lipid profile and a reduced 10-year risk of heart disease and stroke from 11% to 3.3%. This case demonstrates the effect of weight loss on glycemic control and consequent remission in T2DM patients.
Highlights
The development of type 2 diabetes mellitus (T2DM) in adulthood is strongly related to weight gain and excessive accumulation of pancreatic and hepatic fat [1]
Lean et al conducted one of the more valuable studies in this field and demonstrated the effect of weight loss on the long-term course of T2DM, reporting that T2DM remission occurred in approximately half the sample patients [1]
We present a case of a lean patient with T2DM with other comorbidities who achieved complete remission of T2DM by weight loss only
Summary
The development of type 2 diabetes mellitus (T2DM) in adulthood is strongly related to weight gain and excessive accumulation of pancreatic and hepatic fat [1]. A 46-year-old man presented to Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in late December 2016 for poorly controlled T2DM (diagnosed in June 2014) and hypertension (diagnosed in August 2015) He had been unable to pay for his medications or investigations, which prevented him from achieving his treatment goals. At the three-month follow-up examination, the patient’s glycosylated hemoglobin (HbA1c) was elevated (10.8%); his blood pressure was 160/100 mmHg, with no other changes from the initial examination His fasting plasma glucose ranged from 187 to 295 mg/dL (10.39-16.39 mmol/L). After 20 months, the patient presented again and reported he quit all medications one week after his second visit to FDEMC He reported that he relied solely on diet control due to financial restrictions. Examination Electrocardiogram and chest radiography Thyroid stimulating hormone Total thyroxine Free thyroxine Fasting plasma glucose Glycosylated hemoglobin Lipid profile, renal function, liver function panel, and urine and electrolytes Complete blood count, erythrocytes sedimentation rate, C-reactive protein Anti-tissue transglutaminase antibody IgA Total testosterone, sex hormone binding globulin, free testosterone
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