The use of the last generation insulin analogues for the control of diabetes mellitus in real clinical practice

This article discusses the clinical case of managing a patient with type 1 diabetes mellitus, initially treated with multiple injections of first-generation insulin analogues. On this therapy, disease control was unsatisfactory. There were episodes of postprandial hypoglycemia 3 hours after eating. HbAlc level - 8.2%; the patient was 54% of the time in the target glycemic range, 3% of the time - in the hypoglycemic range, and 43% of the time - in the hyperglycemic range. After switching to the last generation insulin analogue (superfast-acting insulin aspart), it was possible to avoid episodes of postprandial hypoglycemia. Subsequently, episodes of nocturnal hypoglycemia occurred, which were managed by switching the patient from two injections of a first-generation basal insulin analogue to one injection of a last-gen-eration basal insulin analogue (degludec). The combined use of the last generation analogues made it possible to achieve normoglycemia without episodes of hypoglycemia (HbAlc - 6.3%, time spent in the target range - 71%, time spent in the hypoglycemic range - 0%).

diabetes mellitus, aspart + nicotinamide, degludec, glycemic variability