Metformin and properly dosed insulin should be sufficient, though you may need more than 20 units of lantus.
You should also be using a basal-bolus dosing regime. Basal is long acting insulin (such as lantus) and bolus is short acting insulin fro when you eat (such as humalog).
You need to learn about diabetes manageme3nt and become responsibile for your own management.
I recommend the following books which should be read and studied and used by all persons using insulin:
- Diabetes Solutions by Dr. Richard Bernstein
- Using Insulin by John Walsh
- Think like a pancreas
The regimen may be aggressive, but not uncommon for a newly diagnosed patient. I do not know what your baseline lab values were (A1c, fasting blood sugars, etc..) But nearly all newly diagnosed patients start oral medications right away and some physicians are more aggressive than others because it is important to get diabetes under control as soon as possible to reduce risk of long term complications. The main concern I would have about the addition to Lantus 20 units daily would be the risk of low blood sugar, especially in combination with glimepiride. Both Lantus and glimepiride can cause low blood sugar or hypoglycemia. Just make sure you're watching for the signs of low blood sugar, which are, sudden headache, feeling shaky, and weakness. There are many more signs of hypoglycemia and I encourage you to research it more yourself. It is also important to know what to do when you recognize signs of low blood sugar. I suggest you have your blood sugar meter near so you can check things out if you feel this way. Low blood sugar is typically defined as a reading below 70mg/dL so have something handy (orange juice) or other quick sugar sources to quickly raise your blood sugar and follow that sugar burst by having a meal or at least a piece of toast. Good Luck!
I am NOT an MD
Keep the metformin 2x a day makes your insulin work better and reduces the liver dumping sugar.
drop the glilmapride 2x a day FORCES the pancreas to make insulin
and can be unpredictable in its effectiveness since it MAKE the pancreas work extra hard, some times it does some times it dont
dont know about the Januvia
Keep the 20units of lantus
*also those drugs lower high BG , eating less carbohydrates will produce less BG. ALL carbs are turned into BG.
JMO