Case Studies Of Continuous Behavioral Patterns Based On Nutritional Ketogenic Diets In The Intervention Of Obesity And Type 2 Diabetes

BackgroundThe prevalence of obesity and type 2 diabetes is high,and the impact on health is serious,and there are limitations in the current mainstream treatment methods in China.Some foreign studies have found that a continuous nutritional ketogenic diet can effectively reverse obesity and type 2 diabetes,and there are few relevant studies in China.For several years,the flash glucose monitor system has appeared in the field of vision as a new technology mainly used to manage type 1 diabetes.To date,it has rarely been used in conjunction with intervention modalities to intervene in the management of type 2diabetes.Objective1.To assess the effectiveness and safety of continuous nutritional ketogenic dietary interventions for weight loss and glucose control.2.Provide a new experimental basis for developing a continuous personalized health management system that is more suitable for overweight,obese or type 2 diabetic patients.MethodsOur intervention program mainly includes personalized nutrition education,continuous monitoring of key indicators,such as beta-hydroxybutyric acid,weight,hunger,mood,energy,continuous flash blood glucose monitoring,etc.It is recommended that participants achieve and maintain nutritional ketogenic state（0.5-1.5 mmol/L）through carbohydrate restriction from the beginning of the study,and adjust carbohydrate intake in time when hypoglycemia occurs.And for patients with type 2 diabetes,reduces or stops the use of anti-diabetes drugs while controlling blood glucose levels within the target range.Results1.After continuous behavioral intervention based on nutritional ketogenic diet,the weight loss and blood glucose control effect were better.The weight of case O₁decreased from 130 kg to 93.63 kg,a decrease of 36.37 kg,a decrease of 27.98%,and the BMI also decreased from 37.58 kg/m~2to 27.06 kg/m~2after 26 weeks of intervention.The weight of case O₂decreased by 25%from 80.4 kg to 60.30 kg and BMI from 29.53 kg/m~2to 22.15kg/m~2after a 19-week intervention.Case O₃after three months of intervention,the weight was reduced from 96.20 kg to 79.94 kg,a decrease of 16.26 kg,a reduction of 16.9%,the BMI decreased from 31.41 kg/m~2to 26.90 kg/m~2,the waist circumference decreased by 16cm,and the waist-to-hip ratio decreased by 5%.Case O₄after three months of intervention,the weight decreased from 76.15 kg to 65.42 kg,a decrease of 10.73 kg,a decrease of14.09%,the BMI decreased from 27.97 kg/m~2to 24.03 kg/m~2,the waist circumference decreased by 12 cm,and the waist-to-hip ratio decreased by 2%.Case O₅body weight decreased from 124.90 kg to 102.21 kg,a decrease of 22.69 kg,a decrease of 18.16%.The BMI was reduced from 41.73 kg/m~2to 34.15 kg/m~2,the waist circumference was reduced by 6.4 cm,and the waist-to-hip ratio was reduced by 1%.Case O₆was an overweight patient who reduced his body weight from 65.0 kg to 55.0 kg,a decrease of 15.39%,a decrease of 15.39%,a decrease of BMI from 24.8 kg/m~2to 20.96 kg/m~2,and a decrease of waist circumference by 6.0 cm after three months of intervention.Glucose metabolism of Case D₁was improved significantly after half a year of intervention.Fasting blood glucose and glycosylated hemoglobin decreased from 6.78mmol/L and 6.2%to 5.52 mmol/L and 5.5%,respectively,and HOMA-IR improved from4.04 at baseline to 0.92.With the exception of weeks 3-4,the remaining TIR was above90%,while all hypoglycemic drugs were discontinued during the first week.After half a year of intervention,glycemic control effect of Case D₂is ideal.Fasting blood glucose and glycosylated hemoglobin were changed from 8.23 mmol/L and 6.0%to 9.9 mmol/L and6.26%,respectively,and HOMA-IR increased from 1.76 at baseline to 2.03,and the ambulatory glycemic profile was ideal（TIR>70%）,while reducing 1 hypoglycemic drug and reducing the dosage of another antidiabetic drug by 1 halve.Case D₃reduced one hypoglycemic drug at the beginning of the intervention.And at week 10,TIR improved from 2.7%to 95.7%and TAR from 97.3%to 3.9%,with an ideal ambulatory glycemic profile.2.Continuous behavioral interventions based on nutritional ketogenicity are relatively safe.In all cases,the emotional and energy scores changed in the range of 3-4 points during the intervention,while the hunger score was between 0-1 points,and adverse events such as muscle twitching and constipation occurred,and the adverse reactions were disappeared gradually by adjusting the program,and no other serious adverse events occurred.The results of the physical examination showed that the high-density lipoprotein,uric acid level of case O₃,triglycerides,glutamine transferase,uric acid level of case O₄,uric acid level of case D₁,and serum creatinine,triglyceride levels of case D₂all improved from abnormal to normal via intervention.There was no significant change in the metabolic indicators of lipid metabolism,liver function,kidney function,and alpha function in other patients.Conclusion1.The results of the case study of continuous behavior based on a nutritious ketogenic diet interventions with overweight and obesity showed desirable weight loss results,while maintaining a better mood,energy and lower hunger.2.The results of the case study of continuous behavior mode intervention in type 2diabetes based on a nutritious ketogenic diet presented obvious glucose relief and could reduce the harm caused by hypoglycemia caused by excessive intervention.3.Continuous behavior mode intervention based on a nutritional ketogenic diet may cause electrolyte disorders,and electrolyte and vitamin supplements need to be supplemented in time.