a raised FBG on patient with metformin/sglt2 | Figure 1
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a raised FBG on patient with metformin/sglt2
64 years old female patient, with metabolic syndrome (already on therapy with statin and antihypertensive with good compliance and DM), being on triple tx with metformin+pioglitazone and SU for years with excellent HbA1c control (6.5%), we decided to stop SU before two months due to night hypoglycemia/morning hyperglycemia (around 180mg) and the levels of FBG were normalised to 100-110mg only with the dual tx. Then, we changed the combination to metformin+empaglifozin (850mg+12.5mg bid) and after one month the FBG values were around 160-170mg. We tried to correct them by increasing metformin to 1000mg and aftwr one month, the values were around 140-150mg. I think we will wait one more month to check the HbA1c (to see the three month control), but would you suggest to change the combination, to try a DDP4 maybe, or adding a third drug, or just wait? I don't know if I will see a change in FBG after waiting for 8 weeks or 12 weeks!
any more info needed, I will be glad to provide.