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05-28-2018 | Lifestyle interventions | Case report | Article

Successful Management of Poorly Controlled Type 2 Diabetes with Multidisciplinary Neurobehavioral Rehabilitation: A Case Report and Review

Journal: Diabetes Therapy

Authors: Zhihui Deng, John Davis, Flor Muniz-Rodriguez, Fran Richardson

Publisher: Springer Healthcare

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Abstract

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.
Literature
1.
Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008;88(11):1254–64. CrossRefPubMedPubMedCentral
2.
Johansen MY, MacDonald CS, Hansen KB, et al. Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JAMA. 2017;318(7):637–46. CrossRefPubMedPubMedCentral
3.
Maislos M, Weisman D. Multidisciplinary approach to patients with poorly controlled type 2 diabetes mellitus: a prospective, randomized study. Acta Diabetol. 2004;41(2):44–8. CrossRefPubMed
4.
Sbroma Tomaro E, Pippi R, Reqinato E, et al. Intensive lifestyle intervention is particularly advantageous in poorly controlled type 2 diabetes. Nutr Metab Cardiovasc Dis. 2017;27(8):688–94. CrossRefPubMed
5.
De Feo P, Schwarz P. Is physical exercise a core therapeutical element for most patients with type 2 diabetes? Diabetes Care. 2013;36(Suppl 2):S149–54. CrossRefPubMedPubMedCentral
6.
Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305(17):1790–9. CrossRefPubMed
7.
Colberg SR, Siqal RJ, Fernhall B, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care. 2010;33(12):2692–6. CrossRefPubMedPubMedCentral
8.
Marwick TH, Hordern MD, Miller T, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119(25):3244–62. CrossRefPubMed
9.
Sanghani NB, Parchwani DN, Palandurkar KM, et al. Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus. Indian J Endocrinol Metab. 2013;17(6):1030–9. CrossRefPubMedPubMedCentral
10.
Vetter ML, Amaro A, Volger S. Nutritional management of type 2 diabetes mellitus and obesity and pharmacologic therapies to facilitate weight loss. Postgrad Med. 2014;126(1):139–52. CrossRefPubMed
11.
Hackett RA, Steptoe A. Type 2 diabetes mellitus and psychological stress—a modifiable risk factor. Nat Rev Endocrinol. 2017;13(9):547–60. CrossRefPubMed
12.
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
13.
Chapman A, Liu S, Merkouris S, et al. Psychological interventions for the management of glycemic and psychological outcomes of type 2 diabetes mellitus in China: a systematic review and meta-analyses of randomized controlled trials. Front Public Health. 2015;3:252. PubMedPubMedCentral
14.
Sudhir PM. Advances in psychological interventions for lifestyle disorders: overview of interventions in cardiovascular disorder and type 2 diabetes mellitus. Curr Opin Psychiatry. 2017;30(5):346–51. CrossRefPubMed