Brief Answer:
changing medicines will help

Detailed Answer:
Dear sir/madam

You are already taking more the maximum dose of metformin. If you still raise the dosage it might not help you further.

Fasting plasma glucose roughly tells the beta cell reserve in pancreas. A high fasting plasma glucose indicates low beta cell reserve. And drugs like glimeperide won't help you further as it will depend on the amount of beta cell reserve.

In this situation you might need to change the medicines. Insulins and gliptins are group of drugs which has beta cell sparing effect. You can ask about the drugs with your doctor and select the groups of drugs accordingly

Hope this information is helpful. Let me know if you need clarification.

Regards

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Brief Answer:
Gliptins and insulin

Detailed Answer:
Dear sir/madam

In this situation, I prefer to start sitagliptin along with metformin. This combination is available as 50 and 100 mg tablets. I would also start basal analogue insulin such as glargine or detemir initially during bed time.

As each drugs have individual indication and contraindications, I would recommend that you check with your treating doctor and start them. I am sure the doctor will understand your needs and oblige. I will be available to guide you further.

Regards

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Brief Answer:
with food or after food

Detailed Answer:
Dear sir

Ideally it should be taken before food but if you have gastritis or hyper-acidity, then you can take it with food or immediately after food.


Thanks

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