Metabolic syndrome—a cluster of interrelated conditions including obesity, hypertension, dyslipidemia, and insulin resistance—is a key precursor to both type 2 diabetes and cardiovascular disease. In regions with rising burdens of non-communicable diseases, diabetes mellitus has become a leading challenge in clinical management. The narrative review presents a detailed case study of a 64-year-old patient who has insulin-dependent type 2 diabetes mellitus with peripheral neuropathy and nephropathy and cardiovascular risk factors. The patient's first presentation, which was defined by hyperglycemia, polyuria, and neuropathic pain, underlined how inadequate his current insulin schedule was. Laboratory and imaging studies revealed a constellation of diabetic complications, including elevated glycated hemoglobin, renal structural abnormalities, and signs of chronic inflammation. A stepwise treatment strategy was employed, shifting from monotherapy to combination therapy, which included insulin optimization alongside antihypertensive and lipid-lowering agents. The research group demonstrated that higher initial doses of NPH insulin led to better early blood sugar control without increasing the risk of hypoglycemia which helped doctors make better treatment choices. The case demonstrates how global blood sugar targets can be achieved through individualized treatment approaches for advanced diabetes management.
