Thank you for the query. As per the information provided, the lady in question is 70yrs old, with a BMI of around 31kg/m2, and a prolonged history of Diabetes mellitus (currently insulin dependent). She also has a permanent pacemaker implantation. I would like to know her Fasting Blood sugar, 2hrs post prandial blood sugar and HbAic (an index which is suggestive of sugar control over the past 3 months). Coming to the problems one at a time. 1. Frequent chest infection - It is quite common to acquire chest infection at the age of 70yrs (infact age more than 65yrs is a risk factor in itself). Sometimes, a single blood sugar reading may be fine, but the HbAic level may be deranged. I would like to ask whether she has any history of chronic obstructive airway disease, any allergy or any history of cardiac ailments (apart from arrythmia, she is already on pacemaker). She needs to be given the vaccinations - Pneumo-vac and Influenza vaccination (if she has not yet received it). Though viral infections are more common, when she has this episode again, please get her total leucocyte count and a chest X-ray done. If she is having bacterial infection, she needs to be given a course of antibiotics. Also if she can produce sputum, it needs to be tested. 2. Frequent UTI - This is again common, specially in aging female subjects. As i have mentioned above, a single blood sugar level may not be sufficient to judge for the control. I would suggest to get a USG of the lower abdomen done, and to assess for her post void residue (PVR) of urine. Raised PVR, increased the risk of frequent UTI. This commonly occur due to a bladder outlet obstruction, and an opinion of urologist may be needed. Please get her Urine for routine examination and culture done. She may need a full course of antibiotics. It is suggested to have adequate intake of fluids and to keep he private parts clean and dry. Fungal infection are also very common, specially in diabetics and local application of Clotrimazole ointment is very helpful. Please visit a physician for physical check up and assessment. Hope this helps you out. Regards Dr. Ayusmati Thakur