Q: My dad is suffering from diabetes since the last 25 years. He has been taking Daonil twice a day and he has got high BP since the last 10 years for which he is taking Aten twice a day. Recently, we came to know that this has affected both his kidneys and at present his creatinine is 4.55. The nephrologist has suggested Monotrate, Laxix, Minipress 2.5 mg, Clopivas, Dexorange, Rantac, Itopride and Emeset. Since he has diabetes, the doctor has suggested insulin but my dad is very weak and his haemoglobin is 8.5. Please help.

A:Its very unfortunate that your father had landed up in diabetes kidney disease, which is quite advanced. This is what happens if someone does not control blood glucose, BP and cholesterol. Now we do not have a choice. None of the oral medicines are advisable at this stage. He has to take insulin only. Very simple pen devices are available in market like Flexpen or Novolet which are very easy to use and with hardly any pain. For his kidneys he is likely to need Dialysis or kidney transplant in future. I again request and appeal to all patients of diabetes to go for the targets to avoid these end stage organ damage. Targets are FBG 80-120 mg/dl, PP < 180 mg/dl, Glycosylated Hb <7%, LDL-Cholesterol<100 mg/dl and BP <130/80. By maintaining these targets one can expect a healthy and complication free life.