Exploring the Impact of Lifestyle Modification, Medical Intervention, and Collaborative Healthcare in Diabetes Management A Comprehensive Case Study

   

Annie Mattilda Raymond, Ankitha Sequeira and Chhavi Mehra^*

Sugar.Fit- Ragus Healthcare Private Limited, HSR Layout, Sector 3, Bengaluru 560102, Karnataka, India

^*Corresponding author: Chhavi Mehra, Sugar.Fit- Ragus Healthcare Private Limited, HSR Layout, Sector 3, Bengaluru 560102, Karnataka, India

Citation: Raymond AM, Sequeira A, Mehra C. (2024) Exploring the Impact of Lifestyle Modification, Medical Intervention, and Collaborative Healthcare in Diabetes Management: A Comprehensive Case Study. Adv Clin Med Res. 5(2):1-8.

Received:  December 6, 2023 | Published: February 14, 2024

Copyright^© 2024 genesis pub by Raymond AM, et al. CC BY-NC-ND 4.0 DEED. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International License., This allows others distribute, remix, tweak, and build upon the work, even commercially, as long as they credit the authors for the original creation.

DOI: https://doi.org/10.52793/ACMR.2024.5(2)-75

Introduction

Type 2 Diabetes is one of the most common metabolic disorders which is characterized by elevated blood sugars, frequent urination, and weight loss associated with many life-threatening complications [1]. The prevalence of type 2 diabetes is drastically increasing among adolescents and young adults due to obesity, family history, and sedentary lifestyle. The onset of diabetes in young adults less than 40 years of age is associated with chronic complications due to long-term exposure to the disease. The global pandemic of overweight and obesity now affects 37% of men, and 38% of women (adults ≥20 years) [2]. Obesity is an important driver for the increasing prevalence of type 2 diabetes in young people and changes in lifestyle account for much of the increased prevalence of obesity and type 2 diabetes [3]. Increasing consumption of energy-dense foods and sugar-rich drinks, and reduced physical activity, are the main contributors to obesity among young people [4]. Approximately a decade post-diagnosis, around 50% of individuals find it necessary to undergo insulin therapy for effective blood glucose management. Given these observations, it has become standard protocol to apprise individuals at the point of diagnosis that they are dealing with a lifelong condition [5].

Calorie excess over many years leads to accumulation of fat in the liver, leading to liver insulin resistance. As the liver consistently synthesizes glucose under the regulatory influence of insulin, the insulin resistance induced by fat in the liver results in a subtle elevation in fasting plasma glucose levels, prompting an escalation in insulin production. This heightened insulin secretion further encourages the liver's conversion of carbohydrates into fat, setting off a self-perpetuating cycle. Moreover, it is theorized that the surplus fat in the liver may lead to an augmented release of fat into the systemic circulation, potentially impacting various tissues, including the pancreatic β cells. Fat is known to decrease acute insulin production, eventually causing increased post-meal glucose levels. In turn, this process would result in higher insulin levels and a greater tendency to store excess carbohydrates as liver fat. The two cycles would continue until a point at which the β cells become unable to produce enough insulin to compensate for the insulin resistance, resulting in diabetes. Importantly, according to the hypothesis, the twin cycles can be reversed if the excess fat load is removed [6].

Lifestyle modifications are universally acknowledged to be the first‑line treatment of T2D, it gives the patients the liberty to live without any intensified restrictions and transform their lifestyle into a healthy one [7]. Lifestyle intervention has repeatedly and conclusively been shown to prevent or postpone the development of type 2 diabetes among high-risk individuals [8]. Patients with diabetes who want to self- manage their condition should generally monitor their blood sugar levels and blood pressure daily and keep them within the target ranges, eat a healthy diet that emphasizes foods with a low glycemic index (GI), exercise regularly, reduce their weight if it is above the recommended range, and give up smoking. Although self-management programs can help manage diabetes, a survey of more than 100 diabetic patients revealed that a technologically based solution might help people manage their condition more effectively [9]. Current evidence from randomized intervention trials suggests that weight loss using a healthy diet with lower saturated fat intake, but rich in vegetables, fruit, and whole grain products is beneficial in the prevention of T2D, especially when combined with physical activity [10]. Change in food habits plays an important role in the Management of type 2 diabetes by modulating or restoring normal glucose levels, thereby decreasing or eliminating the need for medicine/insulin.

This case study highlights the inspiring journey of an individual who joined on a path to reverse diabetes by enrolling in the SugarFits Diabetes Reversal and Management Program (SDRMP). This holistic program seamlessly integrates daily personalized life coaching with expert medical guidance, all with the main objective of empowering patients to regain control of their health and providing them with the tools necessary to facilitate lasting behavioral changes. The study aimed to discover the person's lifestyle and dietary habits, and provide them with personalized, and effective clinical treatment along with empathetic coaching. It also sought to demonstrate the success of a complete program in achieving lasting recovery, metabolic improvement, and the reduction of complications linked to diabetes, which can harm various organs. Additionally, the study aimed to share experiences and knowledge with others in the field.

Case Presentation

This concerns the case of Mr. SG, a 30-year-old male recently diagnosed with type 2 diabetes, hyperlipidemia, and Vitamin B12 deficiency. He presented with an abrupt, unintentional weight loss of 10 kgs over six months, accompanied by severe headaches, fatigue, generalized weakness, and burning feet issues.

Upon learning about Sugrfit’s Diabetes Reversal and Management Program, Mr. SG proactively enrolled in the program in September 2021, to reverse his diabetes. At the time of enrollment, his baseline vitals were recorded as follows: Weight: 75 kgs, Height: 183 cm, BMI: 22.4, Waist circumference: 96 cm, Waist to height ratio: 0.52. He did not report any food or environmental allergies but had a significant family history of type 2 diabetes, with his mother being diabetic. His lifestyle involved a sedentary desk job with 30 minutes of daily walking. His sleep and mindfulness recall did not indicate any concerns, and he had a stable 8-hour sleep routine, despite alternating between day and night shifts every other day.

Hailing from the southern part of India, Mr. SG’s 24-hour dietary recall revealed carbohydrate-heavy meals with irregular food timings and notably low protein intake despite consuming non-vegetarian options occasionally. While he did not admit to indulging in outside eating or excessive consumption of high-fat and high-sugar foods, his continuous glucose monitor (CGM) displayed low tolerance to oats, khichdi, ragi porridge, and ragi ball, but exhibited excellent tolerance to chapati, beans, eggs, and sprouts.

Initially, Mr. SG, conscientious about his eating habits, had eliminated many foods he enjoyed. He expressed confusion about the optimal choices for food, activity, and general habits needed to reverse his diabetes successfully. Consequently, he was assigned a coach who, understanding his challenges and lifestyle choices, provided empathetic guidance toward healthier lifestyle choices.

After receiving the initial diagnostic test results, Mr. SG sought a consultation with Sugrfit’s doctor. Upon confirming the diagnosis of hyperglycemia, the consultant prescribed oral medications (Table 1).

Medication	Dosage	Frequency\Day
JANUMET XR CP	100\1000	1-0-0
ROSUVASF	5	0-0-1
NUROKIND OD	1500	1-0-1