Your blood sugar levels (fasting 220 mg/dL and post-lunch 270 mg/dL) are elevated, suggesting your current treatment needs to be updated. Your medication Tri glynase 1 is a combination of glimepiride, metformin, and pioglitazone. Over four years, the body?s response to diabetes medications can naturally change. Your doctor may suggest safely increasing the doses of these generic medicines, or adding other classes like DPP-4 inhibitors, SGLT2 inhibitors, or insulin to bring your levels into a target range. Please do not change your dosage on your own. I highly recommend consulting your doctor soon, preferably with a recent HbA1c test, to safely adjust your prescription.