Fasting glucose was tested and it came out to be 432; six months ago, it was 115. also has high creatinine, 1.55 and triglycerides are 203. the doctors put him on glimepiride for a month. is it time to consult an endocrinologist now?

Not on metformin?: How comfortable is his doctor treating complicated uncontrolled diabetes. What was his hemaglobin a1c? If it is over 7%= is not good. >8 is very concerning. He has renal issues so i recommend a nephrologist, endocrinologist, opthamologist (rule out retinal problems), and podiatrist (annual foot exams). Optimize diet for sure with high triglycerides. Glimepiride alone not enough to reach goal<7.

Talk With Your Doc: This is a complex case with many considerations. I suggest talking to the treating physician about his/her recommendations for evaluation and management including pro/cons of different therapy options, plan for monitoring response to therapy, need for additional tests to evaluate abnormal lab tests, lab goals of therapy, etc. Following that talk, you may or may not want a second opinion.

Response to meds?: If he has responded well to therapy, referral to an endocrinologist may not be necessary. Referral for diabetes education and nutritional counseling is essential though. If there is not an adequate response to his meds, then either his pcp needs to intensify therapy or refer to endo.