Thank you for the query. As per the information provided by you, your mother and brother are suffering from Type 2 Diabetes mellitus, with fluctuating blood sugar levels despite being on medications. I would like to the know the medications they have been taking. Fluctuating blood sugar levels are more harmful than persistently high blood sugar levels, since they cause more cardiovascular complications. Continuous blood glucose monitoring is done nowadays, with the help of the CGMS (continuous glucose monitoring system), which helps to trace the pattern of the blood sugar at different times of the day and prescribe medications. A new class of drug is being increasingly used, called the incretin mimetics, which has two subclasses - oral DPPIV inhibitors (vildagliptin, linagliptin) and subcutaneous GLP1 analogues (exenatide). Apart from this another new drug Saroglitazar (dual PPAR agonist) is also being used. Recently, FDA has approved of inhaled insulin (Afrezza). Apart form this long acting insulin like Insulin Glargine and Insulin Degludec are being used in the basal regimen. Some other drugs are also in the pipeline, but need approval and marketing before use. Please consult your endocrinologist for a complete check-up, investigations and prescription of the drugs. Hope this helps you out.