Last updated May 29, 2026
Key finding
A 78-year-old man with 40 years of type 2 diabetes and 31 years of insulin therapy discontinued insulin and maintained glycemic control for 77 months after an intensive lifestyle intervention.
This case report describes a 78-year-old man who stopped using insulin after starting a structured lifestyle program and remained insulin-free for over six years. As a single-patient case report without a control group, it shows what happened in one individual but cannot prove the intervention caused the outcome.
Quick read
The essential study design details in one scan.
EvidenceScore™
Low
Study type
non-randomized clinical trial (non-RCT or NRCT)
Follow-up
Long-Term (> 12 mo)
Risk of bias
High Risk
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Plain-language summary
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Study focus
A 78-year-old man with 40 years of type 2 diabetes and 31 years of insulin therapy discontinued insulin and maintained glycemic control for 77 months after an intensive lifestyle intervention.
Published in
Publication details and source links for this paper.
Sustained Insulin Independence Following Lifestyle Intervention in a 78-Year-Old Patient With Long-Standing Type 2 Diabetes: A Six-Year Follow-Up Case Report. Cureus. 2026;[publication details not available]. PMCID:PMC13181349
Insulin discontinuation: Insulin withdrawn in first month and remained discontinued at 77-month follow-up
HbA1c stable: HbA1c decreased from 7.0% to 6.6% at 10 months and maintained at 6.6% at 77 months
Weight and metabolic markers improved: Weight, BMI, triglycerides, HDL, and hs-CRP all improved
Evidence network
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This study contributes evidence to Intensive lifestyle intervention for type 2 diabetes remission and BMI, Body weight, C-reactive protein, and 5 more.
This study contributes evidence to
Primary intervention
Intensive lifestyle intervention for type 2 diabetes remission
Primary outcomes
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Evidence pairs
596
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Intensive lifestyle intervention for type 2 diabetes remission → BMI
Intensive lifestyle intervention for type 2 diabetes remission → BMI
Intensive lifestyle intervention for type 2 diabetes remission → Body weight
Intensive lifestyle intervention for type 2 diabetes remission → Body weight
Intensive lifestyle intervention for type 2 diabetes remission → C-reactive protein
Intensive lifestyle intervention for type 2 diabetes remission → C-reactive protein
Intensive lifestyle intervention for type 2 diabetes remission → Diabetes medication use change
Intensive lifestyle intervention for type 2 diabetes remission → Diabetes medication use change
Intensive lifestyle intervention for type 2 diabetes remission → Fasting insulin levels
Intensive lifestyle intervention for type 2 diabetes remission → Fasting insulin levels
Intensive lifestyle intervention for type 2 diabetes remission → HbA1c
Intensive lifestyle intervention for type 2 diabetes remission → HbA1c
Intensive lifestyle intervention for type 2 diabetes remission → HDL cholesterol
Intensive lifestyle intervention for type 2 diabetes remission → HDL cholesterol
Intensive lifestyle intervention for type 2 diabetes remission → Triglycerides
Intensive lifestyle intervention for type 2 diabetes remission → Triglycerides
Evidence Library
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One 78-year-old man with 40-year history of type 2 diabetes
This is a case report of one patient, not a controlled trial.
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and HbA1c, Diabetes Self-Management Education and Support (DSMES) Programs and Body Mass Index.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies on Diabetes Self-Management Education and Support (DSMES) Programs
Contributes to Diabetes Self-Management Education and Support (DSMES) Programs evidence base.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies measuring Body Mass Index
Measures Body Mass Index as a key outcome.
All studies measuring Body Weight
Measures Body Weight as a key outcome.
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4 results
3 results
4 results
4 results
3 results
Generated from the study's connected evidence using Evidence Intelligence™.
Diabetes Self-Management Education and Support (DSMES) Programs may improve HbA1c.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Moderate | EvidenceScore™ 73.2 | weak positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 30 supporting studies with generally consistent results and a positive effect signal.
Limitations
Diabetes Self-Management Education and Support (DSMES) Programs may improve Body Mass Index.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
BMI
EvidenceScore™ Moderate | EvidenceScore™ 69.7 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Diabetes Self-Management Education and Support (DSMES) Programs may improve Adipokine and Angiogenic Markers.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HDL cholesterol
EvidenceScore™ Emerging | EvidenceScore™ 54.4 | neutral | ConsistencyScore™ Unclear | 1 study
Triglycerides
EvidenceScore™ Emerging | EvidenceScore™ 54.4 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 7 supporting studies with consistent results and a positive effect signal.
Limitations
Diabetes Self-Management Education and Support (DSMES) Programs appears to improve Body Weight.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Body weight
EvidenceScore™ Moderate | EvidenceScore™ 60.2 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 6 supporting studies with consistent results and a positive effect signal.
Limitations
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