Dear patient. Greetings from health care magic!!! I am Dr Thakker and shall be answering your question. I can very well understand your concerns about sugar levels in view of an impaired renal function. Diabetes is a metabolic disease wherein body s insulin secretion and or action are impaired. After 10 to 20 years of uncontrolled diabetes the kidney glomeruli get damaged. This eventually leads to renal failure . This condition is called as Diabetic Nephropathy. Many drugs used to treat diabetes are excreted by the kidneys, metformin being one among them. Hence these drugs are excluded once the kidney failure sets in. In your case the HbA1c is 6.7 which is a good news. A diabetic is expected to be well controlled when HbA1c is 6.5 and around. Your cholesterol levels are normal. This too is a good news for you. Your renal function is not normal as per the nurse. However I wish to know your serum creatinine levels and if you have proteinuria. You could ask your doctor for the detailed report. Metformin is contraindicated when serum creatinine is above 1.5 because of fear of lactic acidosis. Anti-inflammatory drugs are contraindicated in renal failure because they can aggravate the renal damage. I would like to reassure you that in such a situation we have some potent drugs to control your sugars. So do not worry much. You can be given sitagliptin, gliclazide as per creatinine clearance. If need be, regular insulin can be given in renal failure. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker.