<s>[INST] Hello doctor,My father is diabetic as well as a heart patient. Right now we performed a general checkup and in that, they mentioned creatine level is 1.4. How to reduce it? [/INST] Hello. It is impossible to reduce creatinine. As you see diabetes is a progressive disease and it affects the kidney. When we control our blood sugar strictly, we may postpone getting the kidney problem for many years. But if we do not control our blood sugar level strictly, we may get kidney problem soon. The point is, all diabetic people will get a kidney problem. It is only a matter of time. But there are some ways to prevent worsening of kidney problem. The blood sugar must be well below the normal levels. So please take care of your father's blood sugar level and control it, then the creatinine value may go back. Each laboratory has their own normal range based on the reagents and types of tests they do. See what is the normal range given for creatinine. If the normal range is more than 1.4, then no need to be afraid. Since he is also having heart problems, I want to ask you a few questions: 1. Is he having swelling in both legs? 2. Is he having difficulty in breathing even doing his routine activities? 3. Is he passing less urine? 4. Is he already on tablets which increases urination like Lasix or Dytor? If he is not on Lasix or Dytor and he is having swelling, we can start tablet Lasix which reduces the load to heart and kidney. I want to suggest a drug which prevent kidney failure. Please ask your father to start tablet Nefrosave twice a day after food which is good for kidneys. It can be taken with other tablets. Also, do a test called eGFR, which clearly says whether he has kidney problems or not. </s>