Recovery of a Vietnamese Child from Impaired Fasting Glucose and Hyperinsulinemia After one Year of Implementation of an Appropriate Diet Plan: A Case Report

Abstract

Background: Increasing type 2 diabetes mellitus (T2D) in children and adolescents has bypassed the living standard barrier among countries to become a global epidemics. The diagnosis of T2D often focuses on overweight or obese individuals which leaves behind the normal Body Mass Index (BMI) ones whose late diagnosis causes grave complications and consequences. Changing diet and lifestyle are affective means for the management of the disease.Method: A 9-year-old normal weight Vietnamese male with a BMI of 23.3 kg/m2 was diagnosed with impaired fasting glucose (IFG) and hyperinsulinemia a in December 2019 after intensive treatments for severe hair loss progression (Alopecia areata). The patient was under both topical and oral cortisol (4mg of Methylprednisolone and 0.1% Mometasone furoate, daily), fasting blood glucose was 6.6 mmol/L, HbA1C was 5.1%, fasting insulin was 123.048 μU/mL, C-peptide was 4.7 nmol/L and a complete hair loss. His white blood count showed an increase in % Lymphocytes associated with a decrease in: % Neutrophils, number of Eosinophils and number of Basophils. He was born 4.1 kg and his mother did not have gestational diabetes. He adopted an anti-inflammatory diet protocol for the first 6 months which was then extended to high fat low carb diet.Result: After about one year of changing his diet, from May 2020 to April 2021, the patient was off all his medications, his blood test was back to normal (glucose, HbA1C, insulin and C-peptide are 4.22 mmol/L, 4.94%, 3.9 μU/mL, 0.72 nmol/L respectively) and his complete blood count has completely recovered. However, there have been no signs of recovery for his hair loss. Conclusion:The adoption of an appropriate diet is an effective tool for the prevention of T2D progression as well as the management of the disease. Thanks to changes in his diet, the patient has recovered from not only IFG and hyperinsulinemia but also the severe inflammation which, if left advanced, could have led to other complications including the development of polygranular autoimmune disease. Routine screening and early diagnosis of T2D, impaired fasting glucose and hyperinsulinemia are recommended to help patients to avoid serious consequences from the disease complications. Children and adults with normal BMI should be paid as much attention as to those whose BMI is high.