metformin + empagliflozin + insulin glargine

This is a combination therapy consisting of three antidiabetic agents: - **Metformin** is a biguanide that decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. - **Empagliflozin** is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that reduces blood sugar by causing the kidneys to remove glucose from the body through urine. It also provides cardiovascular and renal benefits in patients with type 2 diabetes. - **Insulin glargine** is a long-acting recombinant human insulin analog that regulates glucose metabolism by stimulating peripheral glucose uptake, especially in muscle and fat tissue, and inhibiting hepatic glucose production. This triple combination targets multiple pathophysiological mechanisms in type 2 diabetes mellitus (T2DM): reducing hepatic gluconeogenesis (metformin), increasing urinary excretion of glucose (empagliflozin), and providing basal insulin replacement (insulin glargine). The combination may be used for intensified glycemic control when dual or monotherapy does not achieve target HbA1c levels. Each component has demonstrated efficacy in lowering blood sugar; together they offer complementary mechanisms to improve glycemic control.