Edema or swelling of the body is a well recognized side effect of pioglitazone and other medications belonging to this class. The fact that your EKG and ECHO are normal and renal function near normal is consistent with this fact so stopping the medication is the right thing to do. If you have lost the excess weight and the swelling has resolved after stopping the pioglitazone then this is presumptive evidence that the medication was indeed responsible for the swelling. Amolodipine causes swelling in 15% of all patients it is given to so it not unreasonable to stop that medication as well. If your swelling has resolved with the addition of Amifru I would make no further changes other than ensure you are on a low salt diet. Your physician may consider decreasing the dose of the Amifru in a month or so and seeing whether the swelling reappears. Please note that the recommended BP is now less than 130/80 mmHg in an individual with Diabetes. With regard to your diabetes, the key issue is to ensure a HbA1c between 4 and 6. If after taking maximum doses of metformin and Daonil your HbA1c is above 6 the only option you have is to start taking Insulin. About 5-10% of patients stop responding to medications like Daonil or require higher doses every year so that the natural course is that this class of medication loses its efficacy in nearly all patients in about 10-15 years. It is best that your physician decides whether to add Insulin or not.