Effect of Naturopathic Management in a Patient with Grade I Fatty Liver and Type 2 Diabetes Mellitus: A Case Report

INTRODUCTION

Metabolic syndrome (MS) is characterized by different metabolic disorders, such as obesity, dyslipidemia, diabetes, hypertension, and insulin resistance.¹ Non-alcoholic fatty liver disease (NAFLD) is often linked to metabolic risk factors like obesity, type 2 diabetes, and dyslipidemia in patient’s.² Hyperglycemia is a common risk factor in type 2 diabetes due to insulin deficiency. Among the two major types of diabetes (type 1 diabetes and type 2 diabetes), 90% of the patient’s have type 2 diabetes.³ Around 15–19% of Indian adults are having diabetes and 30% have MS and 38.6% have NAFLD.⁴ Non-alcoholic fatty liver disease includes liver disease, such as liver fibrosis, fatty liver, and steatohepatitis and is considered as a common form of liver disease worldwide.³ There have been few, prior investigations on naturopathy treatments and obesity, type 2 diabetes, high blood pressure, and dyslipidemia but not for NAFLD. These hypotheses frame the study to investigate whether the naturopathic treatments have an effect or not on the specified health parameters over the 12 weeks in the described individual.

CASE DESCRIPTION

A 42-year-old married woman with obesity for 5 years, hypertension for 2 years on conventional medications, type 2 diabetes for 2 years, not on any medications, and NAFLD for the past 2 years visited our clinic in June 2022 with complaints of increased blood sugar levels, increased body weight and known case of fatty infiltrations of liver and was advised to undergo naturopathic interventions at home. Her family history was not contributory. These interventions were followed from July 11, 2022 to October 1, 2022 (12 weeks), monitored daily, and written informed consent was obtained from the subject. The subject was able to assess her blood tests only on 22/06/2022 and 05/10/2022 and ultrasound sonography (USG) of the abdomen on 04/07/2022 and 06/10/2022.

OUTCOME MEASURES

RESULTS AND DISCUSSION

The results of this study showed that body weight, body mass index (BMI), FBS, PPBS, total cholesterol, HbA1c, liver size, uric acid, SGOT, SGPT, alkaline phosphatase, albumin, A/G, while maintaining systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared with baseline, and showed significant changes (Table 2). These results may be due to naturopathic interventions in conjunction with conventional medicine. Hydrotherapy and diet have been shown to play a positive role in lowering blood sugar levels and liver function tests (LFTs). Therefore, the results suggest that the natural therapy not only helped lower blood sugar levels but also improved liver function and liver size.

Insulin resistance leads to adipose tissue dysfunction, altered production and secretion of adipokines, inflammatory cytokines, and mitochondrial dysfunction which may further lead to oxidative stress-related mechanisms.⁶

The outcomes of the current case study are consistent with past research that demonstrated lowered blood glucose and HbA1c levels with dietary and hydrotherapy therapies. According to studies, simply submerging oneself in cold water might alter one’s blood sugar levels.⁵

Increasing energy expenditure might be a tactic to improve certain metabolic states. By boosting cold-triggered thermogenesis in brown adipose tissues, CHB may have increased metabolic rate and enhanced glucose utilization as well as energy expenditure.⁷

Through thermoregulatory adjustments, blood may be drifted to abdominal organs (liver, pancreas, muscle tissue, and numerous others) by GHP application and ameliorate glucose metabolism. The utilization of glucose because of quickened metabolism, downgraded hepatic glucose manufacturing due to expanded blood float (i.e., elevated availability of glucose) to the liver, ameliorated insulin sensitivity due to multiplied metabolism, and expanded glucose-induced insulin secretion because of increased blood float (i.e., enriched availability of glucose) to the body are hence some of the capacity mechanisms for the deduction in blood glucose stages (BGL) followed by a measure of GHP.⁸

Due to its antioxidant, anti-inflammatory, hepatoprotective, anti-atherosclerotic, and anti-diabetic qualities, curcumin, an ingredient in turmeric, may be beneficial for treating type 2 diabetes and NAFLD. By enhancing lipoprotein lipase activity and lowering triglycerides, curcumin treatment for 12 weeks in females with polycystic ovary syndrome (PCOS) confirmed wonderful outcomes on body weight, glycemic control, serum lipids, and PPAR- and low-density lipoprotein receptor (LDLR) gene expression. The reduction of NF-B8 has been identified as one of the main mechanisms behind curcumin’s anti-inflammatory properties.⁹

There are various medicinal benefits of fenugreek. It can lower cholesterol and serum glucose levels. Additionally, it contains hepatoprotective, antioxidant, and anti-inflammatory effects. Blood sugar ranges, inflammation, insulin resistance, liver features, and lipids have all been demonstrated to be favorably impacted by 4-hydroxy isoleucine, diosgenin, and fiber from fenugreek. In addition to increasing insulin secretion, 4-hydroxyisoleucine can block the molecular mechanisms that underlie insulin resistance. It has been tested to enhance blood glucose ranges, insulin sensitivity, and liver gluconeogenesis. Fenugreek reduced triglyceride accumulation inside the liver without affecting blood sugar or insulin levels. They hypothesized that tumor necrosis component-alpha may additionally be vital to this process.¹⁰

The ash gourd contains a variety of phytochemicals, including alkaloids, flavonoids, glycosides, tannins, and phenols. In adipocytes, flavonoids promote glucose transport and lipogenesis. Consequently, it reduces blood sugar levels.¹¹

Our subject’s everyday activities may have benefited from improvements in blood sugar, blood analysis, USG scanning, and maintenance of normal BP. Due to the fact that this case study only involves one instance, the validity and reliability of the findings may differ. No further investigation was done on the person to see whether or not these effects persisted. Therefore, more research with a bigger sample size and more sophisticated methodologies is needed to corroborate our findings.

CONCLUSION

The present case study suggests naturopathy treatment can be considered as an adjuvant to conventional medicine in patient’s with NAFLD associated with type 2 diabetes and essential hypertension.

ACKNOWLEDGMENT

The authors very grateful to the subject who participated in this study and the SDM society for giving a great opportunity to learn.

ORCID

Anjaly Ghosh https://orcid.org/0009-0008-8825-3155

Geetha B Shetty https://orcid.org/0000-0003-0837-2012

Sujatha Kannarody Janardhanan https://orcid.org/0000-0002-7630-3580

Prasanth Shetty https://orcid.org/0000-0003-2760-5643

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