For patients with diabetes and CKD stage 4 with an eGFR of 12, Ondero‑D 10 mg should not be used without direct supervision from a nephrologist or diabetologist. Diabetes management in advanced CKD must be individualised, taking into account kidney function, blood sugar levels, and overall health. In such cases, specialists often consider insulin or other safer alternatives to control blood sugar while minimising risks and protecting kidney function.