What are your preferred type 2 diabetes mellitus management?

* Not Medical Advice!!! *

This thread is to help me to increase my knowledge.

Here's mine:

- base line CMP, A1C, urine albumin/creatinine ratio, c-peptide (to rule out if patient has type 1 DM).

- metformin daily, jardiance (depending on eGFR + albumin/creatinine ratio), MOUNJARO 2.5 mg first month then 5 mg onward (this is the key in my opinion), and long acting insulin (adjust the dose weekly until daily morning fasting sugar between 60-125).

- repeat: CMP, urine albumin/creatinine ratio, A1C every 3 months to monitor and adjust dosage

- if A1C reaches ideal range, cut off insulin and mounjaro, and reduce metformin to 500 mg daily only and monitor vitamin b12 every 3 months.

I personally have achieved ideal A1C level in several patients. One patient with A1C over 11, I have been treating him for 9 months and his A1C now is 6.3! Another one with A1C of 9, now 5.4! and several ither cases.

What's yours?