[Expert Solution]: It has been 6 months since MW’s last DEC visit

It has been 6 months since MW’s last DEC visit. He has been taking 3 medications for his diabetes, at full dose as prescribed. metformin 1000mg BID gliclazide 80 mg 2 tabs bid empagliflozin 25mg daily He has a prescription for basal insulin (10units glargine 100 u/mL) but has not started to take this. His weight has decreased 10 lbs and MW’s recent bloodwork shows an improvement of his A1C to 7.9%. He has occasional mild/moderate hypoglycemia which he treats appropriately. He does express concern that his fasting capillary blood glucose readings are often 9-10mmol/l. This is frustrating as he states, “I am eating less, walking 5 days a week and taking all those medications. What is the point?! I also have diarrhea since starting all these medications.” How would you explain this progression to Mr. MW?