Does a damaged kidney need less or more insulin to help maintain blood sugar levels?

Less. Insulin is actually cleared from the body by the kidneys; therefore, people with diminished kidney function typically require less insulin.
Less. Insulin is usually cleared from our systemvia the kidneys and liver. Most are cleared through the kidney. If you have kidney failure Insulin clearance is decreased thus increasing the time insuling stays in our system. Thus Insulin dose may need to be adjusted as the renal problem worsens.