INS and chronic kidney disease: 2.Where individuals are already receiving treatment with insulin or sulfonylureas, a reduction in dose of these drugs should be considered in people with T2DM and CKD with eGFR > 45 ml/min per 1.73 m2 and HbA1c that is not very high (e.g., < 64 mmol/mol [8%]) so as to reduce the risk of hypoglycemia (Grade 1A).