63 years old male having type 2 DBM for the last 20 years, recently had altered LFT. AST and ALT raised with mild rise of Al phos. He was on metformin, telenagliptin and glimipiride for last 5 years. His fasting blood glucose was 120- 130 and PP went up to 250 with above medication. HbA1C - 6.5% He vegetarian, maintains healthy life style with daily exercise and walking. Does not take alcohol and non smoker. I have put him on insulin humalog 50 in dose 22 unit morning & 20 unit evening.
He is also having metformin 500 in after noon. Above mentioned treatment has been given for last 1 month. His fasting BG is around 130-150 mg and PP is 250-270 mg with this regimen. He is otherwise normal. Renal function and neurological function within normal limits. Now shall I increase dose of drugs or change to longer acting insulin or add sitagliptin.
