Hi, welcome to our site. I am Dr Saumya Mittal, MD. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query First and foremost, I hope the sugars that you have informed us are fasting blood sugars. Random blood sugars and Post prandial blood sugars are of no significance as far as changing therapy are concerned. The rest of the discussion is assuming that the sugars informed are fasting sugars. You can try to step up the dose of metformin. From 500 mg, you can step up to 1 gm tablets. I suggest that you do it slowly. First increase the morning dose of metformin. Take 1 gm tablet. Watch your sugars for 15 days. If the sugars still remain high,. increase the evening dose of metformin also to 1 gm. Again watch for 15 days. It would be better if you increase the doses slowly. Taking 3 medicines can be troublesome. I hope you are taking the combination pill. That way, you can take 1 pill with three medicines combined. Cracks and swelling of penis can be due to skin lesions secondary to sugars. A well controlled sugar may be able to help you resolve the issue as well. Suggest testing FBS, PPBS, Creatinine and HbA1C prior to informing the next sugars. I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this) Best of luck. Dr Mittal. MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)