<s>[INST] I have just been diagnosed with stage 3 kidney disease as a result of diabetes. I had been taking Janumet for 10 years in addition to actose & glimperide. My dr. took me off Janumet and said I must now take insulin. Will I have to do dialysis in the near future? [/INST] Diabetic and IQ stage 3 renal disease...first you were on oral medicine now switch to insulin.it shows you are not controlling your sugar level. As a result your kidneys are effected... We have got two situation .diabetes and renal disease. Well the need for dialysis increases in such patient BUT if your sugar level is controlled within normal range, and you do not have other conditions like hypertension, then you can do it with medicines (angiotensin rennin blockers.Anderton...or ACE inhibitors like lisinopril)for some time. Do your regular blood test and urine test to keep an eye on your kidneys. </s>