Deintensification of insulin therapy in type 2 diabetes mellitus. Clinical case

Using a clinical example of insulindependent type 2 diabetes mellitus in a young woman, the features of clinical symptoms, the course of the disease, and the difficulties of achieving glycemic targets and weight control in a fairly large cohort of patients are examined. Diabetes mellitus is a very common disease that leads to both serious complications and worsens the course of concomitant diseases. According to the World Health Organization, the rate of development and spread of diabetes mellitus is rapidly increasing every year and is gaining momentum as a pandemic. The most common and most disabling type of diabetes mellitus is type 2. Despite a fairly wide range of oral hypoglycemic drugs, a large number of patients are prescribed insulin therapy due to the progressive nature of diabetes and the inability to achieve glycemic targets. This article emphasizes the importance of a personalized and patientcentered approach to patients with type 2 diabetes mellitus. It details the priorities, risks, and potential adverse effects of adding basalbolus insulin therapy to oral agents in patients with type 2 diabetes mellitus. The complaints, medical history, objective status, laboratory and instrumental data of the patient, who had been obese since childhood, had type 2 diabetes mellitus from the age of 31, and was transferred to insulin therapy from the age of 36, are presented in detail. Possible treatment methods are discussed, combinations of various oral hypoglycemic drugs with insulin therapy in different regimens. A scheme for deintensification of insulin therapy and the dynamics of glycemia indicators according to laboratory data, as well as continuous glycemia monitoring, are presented. The analysis of the literature data on the disease was conducted. It is emphasized that it is necessary to regularly observe such patients for timely correction and selection of therapy and reduce the risk of developing both early and delayed complications.