Endocrine Abstracts

Traditional literature has dictated diabetes to be a chronic irreversible disease with progression of micro and macrovascular complications. Modern medicine has now started to include bariatric surgery, starch restriction as potential interventions which could control diabetes at initial stages. Our case report is unique as it illustrates patient directed reversal of diabetes with lifestyle intervention. 77 years old gentleman was diagnosed with Type 2 diabetes at the age of 52 years. C-peptide, anti-islet cell and anti- GAD antibodies. HbA1c 76 on admission. Patient started on oral therapy maximally on metformin 1gm BD, Linagliptin 5 mg OD and gliclazide 80 mg BD. Patient’s BMI 30 kg/m2 on diagnosis. Patient referred to dietician initially and offered lifestyle advice. Patient started dropping weight related to walking 30-60 minutes per day and dropping carbohydrates and fats in meal. As patient was southasian this included interventions like reducing ’rotis’, rice and ’chapattis’ (main carbohydrate source) in diet and oils. With a drop in patient’s BMI a corresponding drop in HbA1c was noted from 70 to 45 in 10 years. Patient’s medications were gradually stopped and he is now off oral medications. Lifestyle advice has been re-iterated however this case report demonstrates the importance of ’simplistic’ measures of diet and lifestyle adapted to a patient’s lifestyle in the so called cure of diabetes.