Lifestyle modification with healthy diet and physical exercise is considered the basic strategy of prevention and treatment of type 2 diabetes, a commonly seen comorbidity in patients with acquired brain injury. Additionally, emotional stress with anxiety and depression is suggested to play a role in type 2 diabetes. Research studies have demonstrated the efficacy of multidisciplinary lifestyle intervention in patients with inadequate glycemic control. However, whether lifestyle approaches alone may be adequate for the management of poorly controlled type 2 diabetes is unknown. We report a 30-year-old male patient whose type 2 diabetes was inadequately controlled by 50 units of insulin glargine, 15 units of insulin aspart supplement with meals plus a correctional scale as well as multiple oral hypoglycemic drugs when admitted to a neurobehavioral rehabilitation unit subsequent to his brain injury. Following 3 months of multidisciplinary rehabilitation for his functional neurological symptom disorder, all his pharmacological agents were gradually discontinued and his diabetes was successfully managed solely by lifestyle approaches.
Pouwer F, Kupper N, Adriaanse MC. Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes (EDID) Research Consortium. Discov Med. 2010;9(45):112–8. PubMed