In a recent study in Colombia, Manuel E Machado-Duque et al, reported in 14,722 patients with type 2 diabetes mellitus and chronic kidney disease, insulin was used by almost 50% of the patients (pooled results of all kinds of insulin) followed by metformin, DPP-4 inhibitors, SGLT-2 inhibitors, GLP-1 analogues and finally sulfonylureas.[46] The combination of therapy is also different e.g., 13.4% of our patients used a combination of DPP4 inhibitors and metformin while in this study only 0.5% of the patients used the same combination.[46]. Here, INS is linked to type 2 diabetes mellitus.