Zita-Piomet 500 Tablet SR is a combination oral antidiabetic medication containing Metformin 500 mg, Pioglitazone 15 mg, and Teneligliptin 20 mg, formulated to improve glycemic control in patients with type 2 diabetes mellitus. Metformin, a biguanide, primarily reduces hepatic glucose production and enhances insulin sensitivity in peripheral tissues, thereby lowering fasting and postprandial blood glucose levels. Pioglitazone, a thiazolidinedione, acts as a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, improving insulin sensitivity in adipose tissue, muscle, and the liver, contributing to better glucose utilization. Teneligliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, prolongs the activity of incretin hormones, which increase insulin secretion and decrease glucagon release in a glucose-dependent manner. The sustained-release formulation ensures a gradual release of active ingredients, promoting steady plasma concentrations and enhancing patient compliance. Zita-Piomet 500 is indicated as an adjunct to diet and exercise to improve glycemic control in adults inadequately controlled on monotherapy or dual therapy. Caution is advised in patients with renal or hepatic impairment, and monitoring for potential adverse effects such as hypoglycemia, edema, or gastrointestinal disturbances is recommended. This combination therapy offers a comprehensive approach targeting multiple pathophysiological defects in type 2 diabetes.