839 - Inpatient and Outpatient Metabolic Rehabilitation with Functional Medicine Interventions: A Case Study on Enhancing Functional Outcomes in Cardiometabolic Syndrome

Case Diagnosis:

A 60-year-old male presented with cardiometabolic syndrome, including type 2 diabetes mellitus (T2DM), hypercholesterolemia, hypertension, and obstructive sleep apnea (OSA). The patient also experienced chronic back pain and post-surgical ankle pain, limiting his physical function. A comprehensive metabolic rehabilitation and physical therapy approach was implemented to address these challenges.

Case Description: The patient participated in a 7-day inpatient metabolic rehabilitation program targeting metabolic health and functional recovery. Key interventions included:

• Tailored nutrition plan focused on insulin sensitivity and lipid regulation, with education on the IFM Elimination Diet and the initiation of the 30-day elimination phase post-discharge.


• Exercise program: Incorporating Zone 2 aerobic training, resistance exercises, and Tai Chi to enhance cardiovascular fitness and musculoskeletal function.


• Stress management through gardening and mindfulness, aimed at reducing systemic inflammation.


• Physical therapy targeting chronic back pain and post-surgical ankle pain.

Following discharge, the patient transitioned to outpatient functional medicine care, which focused on maintaining lifestyle changes, tracking metabolic markers, and overseeing the reintroduction phase of the elimination diet.

Discussions: Within 36 days, the patient demonstrated marked improvements:

• Weight: Reduced from 195 lbs to 186.5 lbs (BMI 31.54 to 30.16)


• Triglycerides: Dropped from 140 mg/dL to 55 mg/dL.


• LDL cholesterol: Reduced from 130 mg/dL to 66 mg/dL.


• Fasting glucose: Lowered from 145 mg/dL to 121 mg/dL.


• Homocysteine: Reduced from 9.6 µmol/L to 4.3 µmol/L.


• Vitamin D (25-OH): Increased from 42.5 ng/mL to 47.9 ng/mL.


• Chronic back pain resolved, and ankle pain improved significantly.

Additionally, the patient reported a 36.8% reduction in subjective negative symptoms, including improved energy, mental clarity, and mobility.

Conclusions: This case illustrates the effectiveness of combining inpatient metabolic rehabilitation with outpatient functional medicine interventions in managing cardiometabolic syndrome. By addressing both metabolic dysfunction and functional impairments, the program achieved significant improvements in the patient’s health, offering a model for treating complex metabolic conditions in rehabilitation settings.