The decision about what medication to use is based on your glucose readings(HbA1c included), complications from diabetes(including kidney function, heart disease etc) and drug availability. This decison is made in combination with your doctor, and isn't normally based on a few glucose spikes, as there may me other reasons for the spikes(infection, diet, changes in exercise etc). Your current drugs are good ones and the Galvusmet contains metformin already, so I wouldn't add extra metformin
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