Hi, diabetic, hypertens, on lantus (insulin glargine) and amaryl 2x3 glucophage5oox4, novonorm2x3 , a1c 9.7 cannot do more excercise due to arthralgia and oa chages ?

More insulin: When diabetes is this poorly controlled on oral medication, incretin therapy and lantus, (insulin glargine) it is time to add more Insulin into the treatment regimen. You will likely require pre-meal insulin. If you have dyslipidemia (likely you do), controlling it better will also help to improve Insulin sensitivity. However, this has to be discussed between you and your doctor. Please do so soon.

We would have no..: Hesitation to stop amaryl, novonorm, add pioglitazone, and glp-1 ra, and a new sglt-2 inhibitor all in effort to reduce hypoglycemic risk if can'y get or too expensive, stop su/glinide and start/titrate rapid analog with meals titrate lantus, (insulin glargine) all assuming patient stayingoff simple carbohydrates see md to translate!