Reduction in HbA1c through lifestyle modification in newly diagnosed type 2 diabetes mellitus patient: A great feat

A 45-year-old male, resident of Texas, U.S.A, was diagnosed with type-2 diabetes mellitus on September 05, 2020 with HbA1c 14.9%. His physician prescribed oral hypoglycemic agents (OHA) starting immediately due to his high HbA1c levels. However, the patient was reluctant to be on lifelong medications. Thus, he chose conservative management of lifestyle modification by enrolling in "World free of Obesity and Diabetes" campaign that advised "only two meals a day and exercise" regime for diabetes reversal. He followed the plan very meticulously and his HbA1c was successfully reduced by 9.8% (HbA1c from 14.9% to 5.1%) within 3 months without any medications. The patient follows the regime without any burden of compromising his quality of life and has maintained his HbA1c to 4.6% till April 2021. Diabetes reversal by lifestyle modification is a healthier option, and must be encouraged in all the patients in prediabetes group (HbA1c: 5.7%-6.4%) and those with newly diagnosed type 2 diabetes mellitus (HbA1c: >6.5%) without any complications, thus promoting good health-seeking behavior. American Diabetes Association (ADA) suggests that metformin should be started to the prediabetes and newly diagnosed group of patients along with lifestyle modifications. However, there are evidences of complete diabetes reversal of the patients with HbA1c ranging from 8%-15% by just lifestyle modification and that too without any complications among the patients registered under "World free of obesity and diabetes" campaign, which challenges the current prescribed guidelines for the management of type 2 diabetes mellitus.