Thank you for your reply@Rosie9876. I have recently stopped taking Dapagliflozin as I believed it was contributing to a nasty outbreak of symptoms. My next HbA1c rose from 59 to 64. Apparently anything above 58 is regarded as needing further action. As I am already taking Metformin, Gliclizide and Trajenta my GP has referred me to the hospital diabetes nurse for advice as the other medication she is considering has to be prescribed by the hospital. During the 3 months since my previous HbA1c I had undergone several painful and stressful conditions causing me to be sedentary and my diet had involved more than my usual carbs so now that I am back on track, have rejoined my walking group and am eating better I am hoping my next test will be back in the normal/ acceptable range and that my hospital appointment doesn't arrive until after then. Like you I am hoping to avoid yet more medications. Best wishes.I had Dapagliflozin 5 mg added to my 3 x Metformin prescription when my A1c was very high. It didn't noticeably reduce it, but switching to a low carb diet months later did. The dapa does give me bouts of constipation, one was very severe. I am keen to come off my meds, but with GP's agreement, now relegated to pharmacist, so far not forthcoming.