Thank you for the query. As per the information provided, your brother is 36yrs old, with a weight of 120kg, hypertensive and diabetic. As per urinary protein quantification he is also having nephropathy. Since his Blood pressure was not controlled conservatively, he was started on Telma 40 mg. Telmisartan (Telma) is the drug of choice in this situation (combination of hypertension, diabetes with proteinuria). This drug abates proteinuria and is shown to be beneficial in albuminuria related to diabetic nephropathy. In fact this drug is kidney protective, however, in the initial stages of starting this drug, the renal parameters (creatinine) may get deranged. The rise in creatinine level (if present) must be monitored. Since the sugar level was once recorded at 204mg%, i would advise to get a complete blood sugar profile done (Fasting, 2hrs post prandial and HbAic). Your brother may need to start antidiabetic medications if the HbAic levels are more than 7.5%. You also need to get his renal function test (Urea, creatinine) done, at least as a baseline. Weight reduction is very important for management of his condition. He may well be suffering from what is known as metabolic syndrome (diabetes, obesity, hypertension). Hope this helps you out. Regards, Dr. Ayusmati Thakur