Elderly male 78 years suffering from type 2 diabetes mellitus. Since the last 15 years, on Glimepiride 2 mg, Metformin 1000 mg and Sitagliptin 50mg with HbA1c 8% even with a strict diet and activity schedule. So, Pioglitazone 15 mg was added before breakfast for three months. Made his HbA1c to 7%. But he gained 5 kg extra weight more of truncal obesity. The patient is also on regular Betahistine 16 mg bd for his vertigo.
He is also known as a case of hypertension on Bisoprolol 5 mg and Telmisartan 40 mg. Seeing his gained weight we stopped Pioglitazone. He has restricted mobility because of spondylitis. Even after reducing his caloric intake his weight did not reduce. What are other alternatives? How can be managed further?
