Outcomes of Physiologic Insulin Resensitization (PIR) in Patients With Chronic Kidney Disease and Type 2 Diabetes Mellitus

This study is testing a treatment approach called Physiologic Insulin Resensitization (PIR) — which involves giving small doses of insulin in a specific pattern to better retrain how the body responds to insulin — in people who have both Type 2 diabetes and chronic kidney disease (CKD stages 3b, 4, or 5). **You may be eligible if...** - You are 18 or older with CKD (stage 3b–5) and Type 2 diabetes for at least 6 months - Your diabetes and kidney treatment has been stable for at least 6 months - You can attend all required study visits **You may NOT be eligible if...** - You have had cancer treatment in the past 2 years - You are pregnant or plan to become pregnant - You have had a severe low blood sugar emergency requiring glucagon in the past 6 months - You have used non-prescription opioids or psychoactive drugs in the past year Talk to your doctor to see if this trial is right for you.