Your blood sugar levels (fasting 172, post-meal 220) are high, indicating that your current combination of four diabetes medications is no longer fully effective. Over nine years of diabetes, the pancreas?s ability to produce insulin naturally declines. You must consult your doctor before making any changes. They may consider optimising your Metformin dose (up to 2g daily), simplifying your oral regimen, or transitioning you to insulin therapy or a GLP-1 injectable medication for safer, more robust control. Please do not adjust these prescription medicines on your own, and continue to monitor your daily diet and physical activity.