Hello, there s not enough information for a specific answer but I ll try to give you the best guidance I can. Type 2 diabetes gets worse over the years and what worked yesterday may not work today. When a drug regimen seems insufficient a careful assessment of the following three factors is needed: (1) diet: changing eating habits may be the reason for hyperglycemia. Increased body weight makes glucose control difficult. Maintaining a healthy body weight is the target. (2) physical activity: not every patient can exercise but those who can, should exercise every day for at least 30 minutes. 30 minutes of fast walking is enough. If a patient already does more than that then it s even better. (3) drugs: if diet and physical activity cannot provide a better glucose control then a change in medications is warranted. First of all, the patient may be taking drugs that impair blood glucose levels (like cortisone or statins). In that case, additional drugs or increased dosages of current drugs will be needed. If no drugs interfere with glucose control then the glucosylated hemoglobin should be assessed (HbA1c), unless the self-measurements are repetitive. If the HbA1c is higher than the target levels or the self-measurements are consistently higher than the target levels then the best action is to either switch to insulin or add a new tablet. The usual next step is adding a tablet because most patients do not like to consider injections (insulin) unless the HbA1c is higher than 8-8.5% and the glucose is not expected to return to the target with non-insulin therapy. The choice of a specific next drug depends on many factors that could not be addressed here, because many aspects of the patient s medical history are missing, like the kidney and heart status, the HbA1c, the body weight etc. I hope I ve given you some insight on diabetes treatment. If you need further guidance, please send me the information and I ll be glad to help you. Kind Regards!