Positive effect of long-term tailored physical activity therapy on diabetes mellitus management in an obese type 2 diabetic patient.

The case history of a 44-year-old, severely obese Caucasian man with serious decompensation of diabetes and subsequent withdrawal of high-dose insulin is reported. Insulin was withdrawn after 5 years of continuous therapy and the patient was treated for 6 months with diet, individualized physical therapy and oral antidiabetic drugs from the group of insulin sensitizers. Six months later, oral antidiabetics were discontinued for low blood glucose levels, and the treatment was limited to therapeutic life style changes. After insulin withdrawal, the patient's condition markedly improved: he showed better diabetes control, decrease in insulin resistance, weight loss, reduced BMI, reduced waist circumference, sagittal abdominal diameter and body fat, increased fitness level, normalized blood pressure and decreased heart rate at rest.