Holistic approach to reversing Grade 2 fatty liver to healthy liver, HbA1c of 10.4% to 6.8 % and reducing Triglycerides from 200 mg/dl+ to within 100 mg/dl

CASE STUDY & SUCCESS STORIES

Name: Raman

Age:50 years

Location:Dubai

Case History: A 50-year-old consultant, following a vegetarian diet, was first diagnosed with type 2 diabetes in 2012. Despite being aware of his condition, his recent blood work indicated that his diabetes was poorly managed. His fasting blood glucose was recorded at 189 mg/dL, and his HbA1c was significantly elevated at 10.4%, suggesting chronic hyperglycaemia and increased risk for diabetes-related complications. To monitor his metabolic response more closely, he is currently using a Continuous Glucose Monitor (CGM) along with an Oura Ring, which allows for real-time insights into glucose trends, sleep quality, stress markers, and physical activity. Additionally, he was recently diagnosed with Grade 2 Non-Alcoholic Fatty Liver Disease (NAFLD) as shown in the ultra sound scan, further supported by elevated liver enzymes, particularly an ALT level of 48 U/L, pointing to ongoing liver inflammation. His BMI was already 22 Kg/m2 and therefore TOFI body type hence we needed to ensure that he sustained his weight but lost fat and gained muscle.

His understanding of healthy foods was flawed. He believed that nuts were a major source of protein and ended up consuming them in excess. Similarly, there was an overconsumption of refined carbohydrates, while vegetable intake was minimal. He also assumed that paneer was high in fat and, as a result, excluded it from the diet.His lifestyle contributes significantly to these metabolic issues. With frequent work-related travel, long hours in a high-stress professional environment, and minimal physical activity, his body has likely been in a chronic state of stress and insulin resistance. Mindless eating during meetings and unplanned meals and consuming food as per availability further worsened his health conditions. The combination of a sedentary lifestyle and elevated stress levels has further compounded both his blood sugar dysregulation and fatty liver progression.

Given these challenges, he sought a personalized nutritional approach that would help reverse his Grade 2 fatty liver and bring his blood glucose levels under control.

Approach by the best nutritionist, and dietician in Hyderabad, Telangana, India Deepika Chalasani

After carefully examining his condition and his diet preferences his diet plan was designed to be vegetarian, simple to follow during travel, meetings and stress-adaptivefocusing on foods that support liver detoxification, improve insulin sensitivity, and reduce lipid profile. Given his blood reports, we designed a plan with a meal composition of 50:20:30. Ensuring that the carbohydrates came from cell wall intact carbs, easy to digest vegetables.

Given his small build and limited appetite, we focused on incorporating a diet rich in steamed vegetable salads, sautéed vegetables, and low glycaemic fruits to support the management of fatty liver, diabetes, and hypertriglyceridemia. Fiber plays a key role in this approach—it enhances insulin sensitivity by slowing glucose absorption, helps reduce liver fat by lowering triglyceride levels, and aids liver detoxification by promoting the elimination of toxins.

Complex carbohydrate sources like brown rice, millet khichdi, quinoa poha, jowar rotis, bajra rotis and steel-cut oats were included in the diet to provide sustained energy, improve insulin sensitivity, and support liver health. These low-glycaemic index foods help maintain stable blood sugar levels, reducing insulin spikes that contribute to fat accumulation in the liver.

To ensure adequate protein intake, the diet included plant-based sources such as moong dal, rajma, chole, and lobia, along with dairy options like low fat homemade paneer, yogurt, small portion of cheese and buttermilk. Additionally, pea protein powder was incorporated to meet higher protein needs without adding excess carbohydrates or fats. Protein plays a crucial role in managing both fatty liver and diabetesit helps preserve lean muscle mass, supports blood sugar regulation, and promotes satiety. For fatty liver, adequate protein intake can reduce liver fat accumulation and improve liver enzyme levels, while in diabetes, it aids in stabilizing blood glucose and improving insulin response.

Understanding the importance of hydration, he was educated to start his day with 1–2 glasses of water early in the morning. This practice supports liver detoxification, kickstarts metabolism, aids in digestion, and helps maintain optimal blood sugar levels.

Guidance was provided to him at every step to ensure he could follow the diet efficiently and confidently. Personalized support helped him understand food choices, portion control, and meal timing, making the plan practical and sustainable. Continuous guidance also empowered him to make informed decisions, especially during travel or social situations, thereby enhancing adherence and promoting better outcomes for managing fatty liver and diabetes.

To further improve his insulin sensitivity, we guided him on accurate strength training and changed his diet accordingly. We monitored is fasting and feasting periods and ensured he remained energetic through the day despite work out

Results:

Despite his busy schedule, he was able to follow the diet diligently, and within three months, he experienced significant health improvements. His weight reduced from 65 kg to 62 kg, but with a higher muscle mass and lower fat percentage and his HbA1c levels dropped from 10.4% to 6.8%, indicating a substantial improvement in blood sugar control. At the end of 3 months Grade 2 fatty liver reduced to grade 1 and at the end of 6 months, the ultrasound did not show traces of any fatty liver.His triglycerides for the past 10 years would always be around 200 mg/dl. For the first time it reduced to less than 100 at the end of 3 months and remained in the range at the end of 6 months. These positive outcomes highlight the effectiveness of a well-structured, nutrient-dense vegetarian diet tailored to support liver detoxification, enhance insulin sensitivity, and promote sustainable fat loss—all crucial factors in managing and reversing both fatty liver and type 2 diabetes and reversing hypertriglyceridemia.

Deepika Chalasani is a Clinical Nutritionist, Mind and Body Transformation Coach, and co-founder of Fit4Life India, an integrated nutrition and wellness organization for Indians that provides complete solutions, addressing health and wellness challenges of individuals by working on their overall well-being. Deepika, the best nutritionist in Hyderabad for weight loss and online dietician can be contacted via email at deepika.chalasani@gmail.com or Mobile at +91 9381525943

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