Lifestyle Changes in Diabetes Prevention: Really Simple but Very Powerful: A Case Report

Research Article

Austin Diabetes Res. 2016; 1(2): 1009.

Lifestyle Changes in Diabetes Prevention: Really Simple but Very Powerful: A Case Report

Wodrich N¹ and Schwarz PEH1,2,3*

¹German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany

²Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Germany

³Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Germany

*Corresponding author: Peter Schwarz, Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany

Received: October 18, 2016; Accepted: November 21, 2016; Published: November 23, 2016

Abstract

Lifestyle characterized through over nutrition and physical inactivity is said to be the main reason for the growing of risk factors for type 2 diabetes mellitus and other chronic diseases. Our case represents simple but powerful lifestyle changes in a person being at risk for diabetes mellitus. Dietary recommendations and improved physical activity significantly reduced visceral fat and liver fat and substantially improved glucose tolerance. This case proves the effectiveness of a simple lifestyle change to prevent chronic diseases. Future strategies of lifestyle intervention should directly targeting different fat compartments with a focus on hepatic fat content reduction.

Keywords: Lifestyle, Diabetes; Liver fat; Adipokine; Prevention; Simple; Powerful

Abbreviations

ALAT: Alanin Amino Transferase; BMI: Body Mass Index; CVD: Cardiovascular Disease; HDL: High Density Lipoproteins; FG: Fasting Glucose; GT, Glucose Tolerance; IFG: Impaired Fasting Glucose; IGT: Impaired Glucose Tolerance; LDL: Low Density Lipoproteins; LI: Lifestyle Intervention; T2DM: Diabetes Mellitus Type 2; TG: Triglycerides; Ogtt: Oral Glucose Tolerance Test

Introduction

Today we observe a growing prevalence and incidence of type 2 diabetes, obesity and other related chronic diseases. Especially the rising prevalence of type 2 diabetes but also the increasing number of persons with prediabetes is often described [1-7]. Societal lifestyle promotes the development of chronic disease risk and the new normality is a common behavior with rich food consumption and physical inactivity. Eating behavior moves from self-preparation of food to marketing driven consumer behavior in a toxic food environment [8]. This behavior and societal changes promote the development of unhealthy lifestyle, building the basis of growing risk factors for chronic diseases, but also the progression of incidence and prevalence of chronic diseases like obesity and diabetes mellitus Besides of the interaction of diabetes and obesity the linking between diabetes, liver fat and visceral fat content is partially understood [9- 16]. The presented case mirrors a characteristic stereotype of persons living in the above described environment and underlines the linking between body weight reduction and changes on glucose metabolism and liver fat content. The case report also presents one method to prevent the development of chronic diseases.

Methodology Section

Case presentation

Our case is a 46 years old German who was unsatisfied with his body shape and weight who was concerned about his individual health when we met for the first time. Since 2004 he had taken angiotensin II receptor blocker 32mg and calcium antagonists 20mg because of hypertension. The patient described a positive family history of Type 2 Diabetes Mellitus (T2DM). His lifestyle is characterized through irregularly eating behavior (a lot of red meat, no fresh food, often fast food) and step counts less than 5000 steps per day. He smokes up to 10 cigarettes per day and reported moderate alcohol consumption.

The patient’s weight was 101, 0 kg, BMI 30, 2 kg/m² with a waist of 106 cm. Blood pressure and physical examination did not show any abnormalities. The laboratory finding showed an Impaired Fasting Glucose (IFG) level (6, 18 mmol/l) and Impaired Glucose Tolerance (IGT) with a 7 hour glucose of 8, 13 mmol/l after oGTT with an corresponding HbA1c of 5, 7%. The Matsuda Index 1,401 and IGI 241, 81 indicated a higher level of insulin resistance, confirming the high risk to develop T2DM within the next years (Table 1) [17- 19]. The patient also presented with dyslipidemia as Triglycerids (TG) 1, 59 mmol/l, Cholesterol 5, 67 mmol/l (LDL 3, 07 mmol/l, HDL 1, 04 mmol/l). Liver enzyme ALAT was elevated (0,99 μmol/ s*l) A specific MR Screening and n axial T1-weighted fast spin-echo technique showed 31, 58% liver fat content and a visceral fat content 7,06 l (Table 1) [20-22]. Patient’s medication included angiotensin II receptor blocker and calcium antagonist for treating hypertension.

Citation: Wodrich N and Schwarz PEH. Lifestyle Changes in Diabetes Prevention: Really Simple but Very Powerful: A Case Report. Austin Diabetes Res. 2016; 1(2): 1009.