INS and Renal insufficiency: The most common strategies for treating diabetes is through (a) increasing insulin levels, either through supplementing insulin directly or the use of drugs that increase insulin production by the pancreatic beta-cells, such as sulfonureas, and incretins, and (b) increasing insulin responsiveness in the liver and skeletal muscle, such as with metformin, despite an appreciation of mechanistic distinctions within the diabetic population, treating diabetes is difficult because of significant and varied co-morbidities, such as obesity, cardiovascular disease and renal failure.