Abstract : Insulin, glimepiride, and metformin prescribe as monotherapy or in combination to control glycemic state. A comparative retrospective case-control study followed by a follow-up study of added metformin and or glimepiride to establish the effect on weight and glycemic state. There are no significant differences in BMI, FPG, and HbA1c among comparative monotherapy groups, follow-up study show a highly significant reduction of glycemic parameters with varying effect on weight among antidiabetic agents. Insulin and its secretagogues glimepiride provide hypoglycemia with the incidence of increased weight while metformin is associated with weight loss. Adding metformin with insulin or glimepiride counterbalances the weight gain with improving glycemia.