Patients given oral hypoglycemic drugs are usually given insulin when their GFR drops to levels below 30 ml/min/1.73m2, and new drugs with enhanced safety characteristics for patients with CKD have been introduced.10,11,17 Individuals previously on insulin therapy are often required to decrease dosages, since insulin is metabolized in the renal tubular cells and has its half-life prolonged in the advanced stages of kidney disease.10,11,17. This evidence concerns the gene INS and chronic kidney disease.