Mr. lybrate-user, Thanks for the query.
From the given information it is clear that she is already on very high dose of Glimepiride
4 X 2 tabs. Usually there is no benefit in giving such a high dose of glimepiride. Plus she is on Vildagliptin also. It is essential to bring blood glucose level to: FBG <100 mg & PP 150 to 170 mg & HbA1c%<6.8, in order to prevent long term complications of diabetes
. Therefore, it is necessary to use Insulin injection like Glargine once a day along with the oral drugs (with a reduction in Glimepiride dose). If you are keen on getting a better control, please come in a private conversation, with following details: current FBG, PP levels, HbA1c%, her dietary pattern and extent of daily exercise. Then I will be able to guide. Please understand it is absolutely essential to reduce the glucose levels. If not with me please do consult your local doctor and take necessary steps. Thanks.