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Revista de la Facultad de Medicina Humana

English Title

Tratamiento y control de la diabetes con intervención de estilo de vida en pacientes ambulatorios: Serie de Casos y Actualización

Keywords

Type 2 Diabetes Mellitus, Plant-Based Diet, Healthy Lifestyle, Remission

English Keywords

Diabetes Mellitus tipo 2, dieta basada en plantas, estilo de vida saludable, remisión

Abstract

The prevalence of diabetes demands the identification of more efficient long-term methods to achieve good patient control. This paper reports the progress of 4 patients diagnosed with previously poorly controlled diabetes and prediabetes with comorbidities that were attended in an outpatient clinic, they received orientation regarding lifestyle change and were instructed to increase consumption of dietary fiber and physical activity. Body composition and biochemical markers were followed and changes were reported. In a 5 month period Patient 1 achieved criterion for controlled diabetes and was able to suspend oral hypoglycemic agents, reducing his body weight by 10%. Within a 8 week period Patient 2 experienced a 50% decrease of HOMA IR and was able to achieve criteria of controlled diabetes. Furthermore a 3 kg increase in lean body mass and a 4 kg body weight decrease were documented. These findings were accompanied by a 23% and 38% decrease in total cholesterol and triglycerides respectively. Patient 3 achieved criteria for type 2 diabetes remission within a 18 month time span(Inicial HBA1C 11.4% Final HBA1C 5.3). Patient 4 progressed to remission of prediabetes and a decrease of 5.9% in total body weight in a 3 month period.

English Abstract

Las cifras de prevalencia de la diabetes nos obligan a identificar métodos más eficientes a largo plazo para lograr el buen control de los pacientes. En este trabajo se reporta el curso clínico de 4 pacientes con diagnóstico de diabetes y prediabetes quienes fueron atendidos en la consulta externa y recibieron asistencia no intensiva para cambio de comportamiento en salud, orientada a aumentar consumo de fibra alimentaria y a aumentar sus niveles de actividad física. Se reportan cambios en indicadores bioquímicos y antropométricos. El paciente 1 en 5 meses logró suspender hipoglucemiantes orales, disminuyendo un 10% de su peso corporal y logrando criterios de prediabetes (remisión parcial). El paciente 2 en un período de 8 semanas logró alcanzar criterios de diabetes controlada, disminuyendo en 50% el índice HOMA IR. Además, se documentó pérdida de 4 kg de masa grasa corporal con ganancia de 3 kg de masa magra. Lo anterior se acompañó de una disminución del 23% del colesterol total y 38% de triglicéridos. La paciente 3 alcanzó criterios de remisión de DM2 durante un seguimiento de 18 meses(HBA1C 11.4% inicial y 5.3% final). La paciente 4 evolucionó a remisión de prediabetes y disminución de 5.9% de peso corporal total en un periodo de 3 meses.

DOI

https://doi.org/10.25176/RFMH.v22i1.4139

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