What next Insulin?

KBR said:

Hi everyone new here but not to Diabetes. wondering what your thoughts are.

Type 2 diabetic for 14 years, 203 pounds, eat around 135 carbs a day, take 2 synjardy (12.5mg empagliflozin + 1000mg metformin) along with 45mg pioglitazone. A1C 56 mmol/mol. Have blured vision, no energy, increased thirst.
What next Insulin?

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I’m wondering if, by the way you express your statistics, that you may not be in the UK?

In UK, there are more than 400 combinations of medications available to treat T2 diabetes, and that does NOT include insulin. If you are elsewhere, unless in a less well Developed country, the chances are there will be similar options.

56 is not a stratospherically high A1c, so hopefully there could be other options available to you.

Maybe try lowering the carbs a bit to see what effect it has? I wear the Abbott freestyle libre intermittently to see which foods affect me most.