Triple Therapy with Empagliflozin, Linagliptin and Gliclazide in a Patient who Refuses Insulin: New Solutions to an Old Problem

Background: Insulin therapy refusal is a common subject in the routine of endocrinologists. New therapeutic options can work around this issue. Objective: To report a case of insulin therapy refusal in a type 2 diabetes patient and how this was handled. Design: Interventional case report with clinical and laboratory correlation. Case Report: 54-year-old man receiving Metformin, 1.7g/d for 2 weeks. Triple oral therapy was considered after refusing insulin. Clinical evaluation and assessment of metabolic profile were completed on admission and 3 months later. The outpatient record was also reviewed. Discussion: The triple therapy with Gliclazide, Empagliflozin and Linagliptin promoted laudable glycemic control, besides additional benefits in the blood pressure and weight loss. Conclusion: Facing the patient's refusal or disinterest to use insulin, new classes of oral antidiabetic drugs are required.