What should be the best line of treatment?

A 53 years old female patient with known case of HTN since 2 years on T.Met XL 50 mg OD, Now having complaints of severe weakness, loss of weight (about 5 kg) in last 10-15 days. Family History : Father : DM , Died due to ? Kidney failure. Mother : HTN. Today's BSL random ( Finger prick) : 461 mg/dl. So , I did all these lab tests. Now, I advised her to get admitted for strict BSL control with Insulin. But she is not ready for admission and wishes me to treat her at home with Insulin due to fear of COVID 19. So, shall I treat her at home or else can I put her on oral hypoglycemics?

(Edited)

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She can be managed at home Not to use sulphonylurea because they cause hypoglycemia Combination of Metformin 500 mg three times a day Sitagliptin 100 mg once a day Glargine insulin 6 units once a day can be given with regular blood sugar charting Glargine insulin titrated upwards of blood sugars are high I would have used this type of regimen at home
Thank you sir
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It is COVID for you also. Manage at home but with VC. Reassurance and counciling required. Orally medicine ,diet control and change in life style bring good result. We must follow your routine and not advise or reluctance of pt. My personal opinion under present circumstances.
Thank you sir
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IT'S A..CASE OF.. ? UNCONTROLLED DIABETES WITH .. HT .. AND.. ? UTI.. * NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * ANTIHYPERTENSIVE AS IT IS.. CONTINUE.. * UTI.. ZENFLOX-UTI..
Tnx Dr Vipin Bihari Jain
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At such high blood sugar leavels , OHA wont help Insulin is required Explain her risk of hyperglycaemic coma Explain her strict blood sugar charting and insulin accordingly, also explain her symptoms of hypoglycaemia
Thank you madam
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Recommended insulin asap....if want can use sglt2- for a while or combo
Thank you sir
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Start with tab. GLYCOMET GP2 bd after food.. 30 days. TAB.TENGLYN 20mg OD after food.. 30 days TAB. VITAGREAT OD for 30 days. For UTI tab. Ceftum 500 bd for 3 days
Thank you sir
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U can treat her...my opinion is to start tab glycomet gp o.5 1bd and inj basal 14u bed time ask her to drink enough fluids
Thank you sir
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UTI
Thank you madam
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