Abstract. Due to the widespread and rapid growth of the disease, the development of complications, premature disability and high mortality of patients, type 2 diabetes mellitus (DM 2) remains the important medical and social problem. The increase in the number of patients with diabetes mellitus is primarily determined by patients with DM 2, especially the elderly. Despite the variety of medications in the doctor’s arsenal, the problem of choosing optimal schemes of hypoglycemic therapy is still relevant. At the same time, next to the choice of medications for the treatment of DM 2, lifestyle modification, adherence to therapy and control of the disease on the part of the patient is of importance. In the clinical cases cited in the article, a comparative characteristic of the disease dynamics of two patients with DM 2, with a complicated course, who are on various hypoglycemic therapy, is presented. The example focuses on the influence of risk factors on the prognosis and course of the disease, as well as the choice of a treatment strategy aimed at the key processes of development and progression of diabetes mellitus.

Keywords: multifactorial approach, combined hypoglycemic therapy, glycemic control, type 2 diabetes mellitus, cardiovascular diseases, risk factors