Her fasting blood sugar of 158 and after-meal level of 311 are elevated. After 12 years of diabetes, the body's response to treatment naturally changes, meaning her current medications?Gluconorm G1 (glimepiride/metformin) and Tenglyn 20 (teneligliptin)?may need a dosage adjustment or a treatment update. Please do not worry, as this is a very common part of managing long-term diabetes. I highly recommend scheduling a consultation with her doctor to safely adjust her therapy. In the meantime, keeping a daily log of her blood sugar readings will be extremely helpful for her physician.

Your fasting sugar of 272, post-meal of 416, and HbA1c of 12.7% show that your diabetes is currently undercontrolled. Gluconorm 1000 (metformin) is your only blood-sugar-lowering medication, as Pandop D and Darolac are for digestion and acid reflux. While limiting sweets is excellent, other carbohydrates also impact glucose, and your body likely needs more support right now. Please visit your doctor soon to discuss adjusting your treatment. You may need additional glucose-lowering medications or insulin to safely and gently bring these numbers back to a healthy range.

The whistling sound you hear during the Valsalva maneuver, especially after using cotton swabs, strongly suggests a small tear or perforation in your eardrum. Since you are managing diabetes and taking immunosuppressive medications, your body's ability to fight off infections is reduced. This makes it very important to avoid self-treating with over-the-counter drops, as they may not be safe for a torn eardrum. I gently recommend consulting an ear, nose, and throat specialist promptly to safely examine your ear and prevent infection.

You should take Gluconorm G4 Forte (glimepiride and metformin) shortly before or with your first main meal of the day, usually breakfast. Janumet 50/1000 (sitagliptin and metformin) is best taken with meals?such as breakfast or dinner?to help prevent stomach upset. Since both of these medications contain metformin, taking them with food is highly recommended. Please follow your doctor's exact prescribed schedule to safely manage your blood sugar.

Given your three-month average, attempting to manage your blood sugar through diet and exercise is a very safe and highly reasonable next step. Slightly elevated fasting blood sugar can often be improved by adjusting evening meals and staying active. I encourage you to partner with your doctor to monitor your progress as you transition to lifestyle management.

Your blood sugar levels (Fasting: 221 mg/dL, Post-meal: 310 mg/dL) are significantly high and require immediate medical attention. Since you have had diabetes for 5 years, your current treatment plan needs adjustment. I cannot prescribe specific medications without evaluating your kidney function, liver function, and HbA1c levels. Depending on your health profile, a doctor may adjust your Metformin dose, or introduce medications like SGLT2 inhibitors, GLP-1 receptor agonists, or insulin to safely lower your levels. Please consult your physician immediately for a personalized prescription. Meanwhile, stay hydrated and limit carbohydrate intake.