Intensification of diabetes therapy using insulin degludec. A series of atypical clinical cases

Diabetes mellitus (DM) is a polygenic and multifactorial disease. It can also be caused by certain diseases. The article presents clinical cases of the manifestation of DM during treatment or after the disease. The use of a number of drugs, for example corticosteroids, is often accompanied by hyperglycemia, which is not always transient and after discontinuation of therapy the diagnosis of diabetes is verified. In the first clinical case, during treatment of hemolytic anemia, the patient was diagnosed with hyperglycemia, which was later verified as diabetes. Scientific papers describe cases of the onset of diabetes after a viral infection. For example, the manifestation of diabetes after rubella, as demonstrated in the second clinical case. The features of glycemic correction in this category of patients and the possibility of intensifying glucose-lowering therapy using insulin degludec are described. The effectiveness of therapy was assessed based on self-monitoring of glucose with assessment of self-monitoring diaries, glycated hemoglobin levels, data from continuous glucose monitoring using Libre sensors, followed by assessment of indicators through the LibreView application. After correction of hypoglycemic therapy using insulin degludec, achievement of target glycemic values with a minimal risk of hypoglycemia was recorded. These clinical examples emphasize the importance of an integrated approach to the examination and treatment of patients.