Brief Answer:
Dose adjustment according to heart & kidney status may be helpful.

Detailed Answer:
Hi Mr. XXXXXXX
Thanks for your question.
For blood sugar control you are taking Tab Janumet (50/500) which contain metformin 500mg & sitagliptin 50mg.

Depending upon your kidney function and heart pumping there are following options for better blood sugar control that can be considered along with your current treatment. That should be discussed with your treating doctor.
1) Increase the dose of metformin to maximum tolerable dose.
2) Addition of SGLT 2 inhibitors or Sulfonyl ureas may be helpful.

In addition you should
1) Check your HbA1c level.
2) Take lipid lowering medicine statin even with normal lipid level only dose will depend on your lipid levels after discussing with your treating doctor.
3) Screening for diabetic complications like fundoscopy for diabetic retinopathy, foot examination for neuropathy and vasculopathy.
4) Regular Blood pressure check up.

Hope this may be helpful to you.
I will be happy to answer your follow up query. Otherwise close the question and rate it.

Regards,
Dr. Abhay Mali.
Diabetologist.

---

Brief Answer:
Dose of metformin can be increased.

Detailed Answer:
Hi Mr. XXXX,

You can increase the dose of metformin but not sitagliptin.
You are taking Tab Janumet (50/500) twice a day which provide you sitagliptin 100 mg daily which is a maximal recommended dose and metformin 1000 mg per day.
Dose of metformin can be increased up to 2000 mg depending on your kidney function and heart pumping (2DEcho report) and gastric tolerance.
Additional dose of metformin can be taken as separate tablet once or twice a day depending on dose along with Tab Janumet twice a day, but you should discuss it with your treating doctor first.

Hope I have answered your question.
If so close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

---