**Figure 21.**

*Helen's relative values of HbA1c, BMI, and INS/d over 12 months show a rapid HbA1c decrease after the initiation of insulin therapy. BMI values indicate an irregular, subtle fluctuation in the range of no larger than 6%. Considering the alternative use of manual/SmartGuard/manual mode, changes in INS/d, body, HbA1c, and increased satisfaction with the pump one can assume gradual but adequate metabolic compensation based on successful education and flexible management of the hybrid insulin pump.*

**Current goal:** to reduce HbA1c below 42 mmol/mol, management of hypertension and hyperlipoproteinemia, and monitoring of ketones by means of Galileo Glu/Ket.
