When it is used, a long-acting formulation is typically added at night, with oral medications being continued. Doses are then increased to effect (blood sugar levels being well controlled). When nightly insulin is insufficient, twice daily insulin may achieve better control. The long acting insulins glargine and detemir are equally safe and effective, and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010. In those who are pregnant, insulin is generally the treatment of choice. Blood pressure lowering
Many international guidelines recommend blood pressure treatment targets that are lower than 140/90 mmHg for people with diabetes. However, there is only limited evidence regarding what the lower targets should be. A 2016 systematic review found potential harm to treating to targets lower than 140 mmHg, and a subsequent review in 2019 found no evidence of additional benefit from blood pressure lowering to between 130–140mmHg, although there was an increased risk of adverse events.2015 American Diabetes Association recommendations are that people with diabetes and albuminuria should receive an inhibitor of the renin-angiotensin system to reduce the risks of progression to end-stage renal disease, cardiovascular events, and death. There is some evidence that angiotensin converting enzyme inhibitors (ACEIs) are superior to other inhibitors of the renin-angiotensin system such as angiotensin receptor blockers (ARBs), or aliskiren in preventing cardiovascular disease. Although a more recent review found similar effects of ACEIs and ARBs on major cardiovascular and renal outcomes.
Guaifenesin/phenylephrine is a combination of the drugs guaifenesin and phenylephrine and is a preparation against the symptoms of cold, flu and allergy. Guaifenesine is an expectorant, phenylephrine is a decongestant. The drug is sold under the brand name Entex and as generic brands. Entex La is 400 mg guaifenesin and 30 mg phenylephrine hydrochloride. Entex Pse is 600 mg guaifenesin and 120 mg phenylephrine hydrochloride. Both are extended release products, meaning that the non-active ingredients are chosen to dissolve slowly to provide a prolonged therapeutic effect. Guaifenesin
Guaifenesin is an oral medication used to try to help cough out phlegm from the airways. It is often used in combination with other medications. It is believed to work by making airway secretions more liquid. Side effects may include dizziness, sleepiness, skin rash, and nausea. Guaifenesin has been used medically since at least 1933. It is available as a generic medication and an over-the-counter drug. Phenylephrine

Phenylephrine is an oral medication primarily used as a decongestant. It is a selective α1-adrenergic receptor activator which results in the constriction of both arteries and veins. Common side effects include nausea, headache, and anxiety. Phenylephrine was patented in 1927 and came into medical use in 1938. It is available as a generic medication. == References ==