Inclusion Criteria:  Male and female patients. Type I and type II diabetes mellitus. Patients on insulin and/or oral hypoglycemic therapy. Duration of diabetes more than 5 years. Medical and surgical patients.  Exclusion Criteria:  Severe persistent hypotension (SBP <80 inspite of receiving 1000ml of normal saline). Acute myocardial infarction. Progressive renal failure or end stage renal disease defined as eGFR < 15ml/min. Liver cell failure. Pregnancy. Need for emergency surgery