A case of a 48 years old obese patient with diabetes mellitus type 2, whose disease progressed and required an introduction of insulinotherapy consisting of evening dose of insulin basal and combined OAD, is presented. An intensification of insulin treatment was made step by step up to the final regimen basal-plus.
A long-term acting analogue was supplemented by one daily dose of insulin glulisine, which resolved insulinoresistence that persisted to morning hours. The final regimen lead to 2.8% reduction of HbA1c and despite high doses of insulin patient reduced his weight by 2 kg.