INS and Hypoglycemia: Insulin is eliminated by the kidneys, and patients with renal failure have a higher risk of developing hypoglycemia.24 Therefore treatment guidelines recommend lower insulin doses for patients with renal failure.25 This recommendation is supported by results of an inpatient randomized control study, that in patients with a glomerular filtration rate ≤45 mL/min/1.73 m2 a lower total daily dose of insulin (0.25 units/kg) reduced the risk of hypoglycemia compared to a standard dose (0.5 units/kg ) without hindering glucose control.26