<s>[INST] I am diabetic with low dosage of human mixtard insulin inj.(10 U-8U0,GLYNASE  1/2-1/2  and hypertensive with telsatran 40 and easm 5 daily .Taking ALFAD3=SHELCAL.SUGAR and BP under control.Creatinin was 1.6 for long with blood urea under 40 for long..recently creatinin increased to 2.0 and blood urea 55.uric acid crystals seen in urine and blood uric acid is 9.0..what medication should I take in addition to contol this quickly,,No swelling anywhere,no gout visually seen . [/INST] Hi overthinks for posting your query o Chat Doctor You are developing diabetic nephropathy which is a long term complication of diabetes. To avoid kidney dysfunction following should be done.1. Round the clock sugar control with target HbA1c 2. Use of ACE inhibitors or ARB Chat Doctor.  Avoid nephrotoxic agents like antibiotic niacin, radio contrast decor further evaluation get USG kidney, urinary blade and ureter. This not only gives you information regarding structural changes of kidney but can rule other causes of raised creatinine for example stone, sometimes it happens raised creatinine in the presence of diabetes take as diabetic nephropathy and later on turn out obstructive myopathy which can be corrected by releasing obstruction Hope this information may be helpful to you. Take care </s>