Q: I am a diabetic for the past 20 years. I take Human Insulin Mixtard twice a day 18 and 12 Units. No matter what I do on medicine or diet I cannot control blood sugar level. My kidneys have also been affected due to this. What should I do?

A:Controlling diabetes is often difficult and depends on a number of different aspects of treatment, which include proper dietary advice, blood sugar monitoring if possible, and of course getting the right dose of insulin and the right type of insulin. Human Mixtard insulin is a very good preparation which we use a lot in the UK. Your present dose of 18 units in the morning and 12 units in the evening is quite a small dose and can be increased until the blood sugar levels are satisfactory. Many patients take much more insulin than you are now doing, and anything up to 80 to 100 units daily is not uncommon. Obviously, you should adjust the dose in consultation with your doctor. If you do have diabetic kidney damage, then it is very important to take proper blood pressure treatment, and this can slow down the progression of this disease. Obviously once again this needs to be undertaken by consultation with your doctor.