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When lifestyle interventions, metformin, and a generic medicine for metformin oral antidiabetic agent are not effective in maintaining the target glycemic goal in patients with type 2 diabetes mellitus, ADA and other clinicians generally recommend the addition of insulin therapy.acute congestive heart failure excessive alcohol intake, and hepatic impairment.

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With levels like yours, you need to check for ketones - do you have urine test strips for ketones?Differing effects of metformin on glycemic control by race-ethnicity.

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