A clinical case of individualizing type 2 diabetes mellitus treatment using combination therapy with oral hypoglycemic agents and ultra-long-acting insulin degludec

Petunina N.A., Goncharova E.V.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Background: The timely and rational use of innovative groups of hypoglycemic agents, including as part of combination therapy, facilitates individualization of therapy and enables significant advances in diabetes treatment. Despite the diversity of hypoglycemic agent classes for the treatment of type 2 diabetes mellitus (DM2), the issue of initiating and intensifying insulin therapy remains relevant and in demand. Basal insulin is the most feasible option for planned intensification of hypoglycemic therapy when other optimal treatment regimens are ineffective or intolerant, with a moderate increase in target glycemic control. 
Description of the clinical case: This clinical case demonstrates approaches to individualizing the choice of basal insulin in combination with oral hypoglycemic agents and reveals the long-term potential of positive metabolic memory for the prevention of microvascular, macrovascular, and other complications of diabetes in the long term.
Conclusion: It is necessary to overcome physicians’ clinical inertia in initiating and intensifying insulin therapy. The choice of basal insulin therapy regimen requires individualization for each individual case, taking into account the characteristics of the drugs and the clinical characteristics of the patients.

For citations: Petunina N.A., Goncharova E.V. A clinical case of individualizing type 2 diabetes mellitus treatment using combination therapy with oral hypoglycemic agents and ultra-long-acting insulin degludec. Pharmateca. 2025;32(8):108-111. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.8.108-111

Authors’ contribution: Article concept and literature review – N.A. Petunina, E.V. Goncharova. Writing – E.V. Goncharova. Editing – N.A. Petunina. Approval of the final version of the article – N.A. Petunina.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data.

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About the Authors

N.A. Petunina, Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Endocrinology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; napetunina@mail.ru, ORCID: https://orcid.org/0000-0001-9390-1200
E.V. Goncharova, Cand. Sci. (Med.), Associate Professor in Endocrinology, Associate Professor of the Department of Endocrinology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; goncharova_ev@list.ru, ORCID: https://orcid.org/0000-0001-7025-8427

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