Evidence map›Paper›PMID 42158779›Full record

ArticleCureus2026

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.

Pramod Tripathi, Nidhi S Kadam, Thejas Kathrikolly, Malhar Ganla

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In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Pramod TripathiDepartment of Research, Freedom From Diabetes Research Foundation, Pune, IND.
Nidhi S KadamDepartment of Research, Freedom From Diabetes Research Foundation, Pune, IND.
Thejas KathrikollyDepartment of Research, Freedom From Diabetes Research Foundation, Pune, IND.
Malhar GanlaDepartment of Management and Exercise Science, Freedom From Diabetes Clinic, Pune, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Insulin dependence in elderly patients with long-standing type 2 diabetes (T2D) is common due to progressive β-cell decline, and insulin withdrawal is rarely considered. Evidence on sustained insulin discontinuation and long-term glycemic stability following intensive lifestyle interventions (ILIs) in elderly patients with long-standing T2D is limited. This case report describes a 78-year-old man with a 40-year history of T2D and 31 years of insulin therapy who achieved insulin independence after a structured ILI program. The multidisciplinary protocol incorporated a whole-food, plant-based diet, intermittent fasting, yoga, resistance training, and stress management, with medication deprescription guided by the Research Society for the Study of Diabetes in India-Endocrine Society of India (RSSDI-ESI) Therapeutic Wheel, monitored through daily remote tracking of glucose levels. Insulin was successfully tapered and discontinued within the first month of enrolment. At 10 months, weight decreased from 71.9 to 62.5 kg, body mass index (BMI) from 24.9 to 21.6 kg/m², and glycated hemoglobin (HbA1c) from 7.0% to 6.6%. Lipids and inflammation improved (triglycerides, 59 to 41 mg/dL; high-density lipoprotein cholesterol (HDL-C), 53 to 62 mg/dL; high-sensitivity C-reactive protein (hs-CRP), 0.7 to 0.3 mg/L), and renal function remained stable. At the 77-month follow-up, the patient maintained an insulin-free status on minimal oral therapy (gliclazide), with stable weight (63.5 kg) and HbA1c (6.6%). Fasting insulin (4.2 μU/mL) and C-peptide (1.36 ng/mL) levels confirmed preserved endogenous insulin secretion. This case illustrates that even elderly patients with very long-standing T2D may achieve sustained insulin withdrawal in the context of comprehensive ILI, underscoring the importance of integrating lifestyle medicine into diabetes care to reduce polypharmacy and enhance long-term outcomes.

Indexed as

geriatric diabetesinsulin deprescribinginsulin discontinuationlifestyle interventiontype 2 diabetes

Identifiers

PMID42158779
PMCPMC13181349

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.