Self-monitoring of blood glucose: from theory to practice in effective diabetes management

Background: This clinical case demonstrates the value of a participatory approach in the treatment of patients with type 2 diabetes with long-term decompensation. The case demonstrates that even with initially low treatment adherence, patient engagement in disease management using digital technologies, education, and lifestyle modification can significantly improve metabolic parameters.

Description of the clinical case: A 61-year-old patient with a long history of type 2 diabetes mellitus and severe decompensation consulted an endocrinologist. The initial data indicated a significant disturbance of carbohydrate metabolism (HbA1c – 12.5%, fasting glucose – 13.2 mmol/L), stage 1 obesity (BMI 30.2 kg/m²). At the time of presentation, the patient received fixed-dose hypoglycemic therapy: metformin 1000 mg twice daily, insulin glargine 40 U, insulin glulisine 10 U before meals. Self-monitoring of blood glucose was performed irregularly. The therapeutic intervention consistently included: structured self-monitoring of blood glucose using a glucometer and a mobile app; training in the rules of calculating BE and adjusting insulin therapy; dietary correction and introduction of regular physical activity; transition to an intensified insulin therapy regimen. After three months of follow-up, significant positive dynamics were recorded: HbA1c decreased to 8.5%, fasting glucose to 5.3 mmol/L. A 3 kg weight loss was noted (BMI 29.3 kg/m²).

Conclusion: Regular structured self-monitoring of blood glucose using modern digital technologies significantly increases patient awareness and adherence to the therapeutic regimen. Active patient involvement in disease management is a crucial factor for success, even in patients with a long history of diabetes and low initial motivation. The use of mobile apps for blood glucose and nutrition monitoring makes diabetes management more transparent, convenient, and analyzable, which contributes to the stabilization of the condition.