Elderly patient with long-standing diabetes achieved sustained insulin independence through lifestyle intervention
Key Takeaway:
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.
Study at a Glance
What was studied
Intensive lifestyle intervention for insulin discontinuation in an elderly patient with long-standing type 2 diabetes.
Study Type
non-randomized clinical trial (non-RCT or NRCT)
duration
Long-Term (> 12 mo)
Intervention
Multidisciplinary lifestyle intervention for type 2 diabetes remission
Outcomes
Diabetes medication use, HbA1c, Body weight, BMI, Triglycerides, HDL cholesterol, C-reactive protein, Fasting insulin levels
Funding
Non-Industry Sponsored
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Main Effects
Insulin discontinuation: Insulin withdrawn in first month and remained discontinued at 77-month follow-up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 Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) |  BMI (Weight & Anthropometrics) | Decrease | Strong |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) | Body weight (Weight & Anthropometrics) | Decrease | Strong |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) |  C-reactive protein (Metabolic Health) | Decrease | Mixed |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) |  Diabetes medication use change (Adherence & Engagement) | Decrease | Strong |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) | Fasting insulin levels (Metabolic Health) | Uncertain | Mixed |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) |  HbA1c (Glycemic Control) | Decrease | Mixed |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) | HDL cholesterol (Metabolic Health) | Increase | Mixed |
Intensive lifestyle intervention for type 2 diabetes remission (Behavioral & Lifestyle) | Triglycerides (Metabolic Health) | Decrease | Mixed |
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Evidence Suggest
- This is a single-patient case report describing outcomes in one 78-year-old man.
- The intervention included multiple simultaneous components, making it impossible to isolate which elements contributed to outcomes.
- The patient continued oral diabetes medication (gliclazide) throughout follow-up.
- Preserved C-peptide and fasting insulin at 77 months indicate residual beta-cell function.
Who this applies to
One 78-year-old man with 40-year history of type 2 diabetes
Keep in Mind
This is a case report of one patient, not a controlled trial.
Between the Lines
- Single-patient case report with no control or comparison group.
- Multiple intervention components introduced simultaneously.
- Continuation of oral diabetes medication (gliclazide) throughout follow-up period.
- No way to determine if outcomes were due to the intervention or natural disease variability.
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Journal Reference
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
Connected Evidence
Discover how this study fits into the broader diabetes evidence landscape.
This study contributes to evidence on Lifestyle Programs and Body Weight, Lifestyle Programs and Body Weight.
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Questions this evidence helps answer
Key clinical and research questions this study contributes to.
Does intensive lifestyle intervention for type 2 diabetes remission improve BMI?
Based on connected evidence for Intensive lifestyle intervention for type 2 diabetes remission and BMI.
Does intensive lifestyle intervention for type 2 diabetes remission affect Body weight in people with diabetes?
Exploring evidence on Intensive lifestyle intervention for type 2 diabetes remission and Body weight outcomes.
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