Q: I am 60 years old and an insulin dependant diabetic since the last two years. The quantity of insulin is on the increase starting with 5 units and now I am on 30 units twice daily. Will this keep increasing? Of late, oedema too is happening on the ankles. Pleas help.

A:You have Type 2 diabetes mellitus (DM). Swelling may be either due to kidney involvement or due to insulin high doses. Please inform the type of insulin you are taking and what are the latest levels of blood glucose and HbA1C. For your kidneys get blood urea, serum creatinine and urine routine exam done. If urine is positive for albumin, get 24 hours protein in urine along with creatinine. There is no harm in taking high insulin doses. The idea is to control blood glucose with whatever insulin dose. In general, insulin requirement does not exceed one unit per kg per day.