Glykrez Total 60 Tablet SR is a combination oral antidiabetic medication containing Gliclazide (60 mg), Pioglitazone (15 mg), and Metformin (500 mg), formulated to improve glycemic control in patients with type 2 diabetes mellitus. Gliclazide, a sulfonylurea class agent, stimulates pancreatic beta cells to enhance insulin secretion, thereby reducing blood glucose levels. Pioglitazone, a thiazolidinedione, improves insulin sensitivity in peripheral tissues such as muscle and adipose tissue by activating peroxisome proliferator-activated receptor gamma (PPAR-γ), facilitating increased glucose uptake and utilization. Metformin, a biguanide, primarily decreases hepatic gluconeogenesis and improves peripheral insulin sensitivity, contributing to overall glycemic regulation. The sustained-release (SR) formulation ensures a gradual release of active ingredients, promoting steady plasma drug concentrations and enhancing patient compliance through reduced dosing frequency. Glykrez Total 60 is indicated as adjunctive therapy to diet and exercise for adults inadequately controlled on monotherapy or dual therapy. Caution is advised in patients with renal or hepatic impairment, heart failure, or risk factors for lactic acidosis. Regular monitoring of blood glucose, renal function, and liver enzymes is recommended during therapy. This combination therapy offers a comprehensive approach targeting multiple pathophysiological defects in type 2 diabetes, aiming to achieve optimal glycemic control and reduce the risk of diabetes-related complications.