I am currently rated at 20% for DMII. A few months ago, my private doctor replaced my oral meds with insulin - Humalog and Lantus. He signed a form 4138 statement describing this change; it included a sentence which I believe clearly states that I have a "regulation" of activities. I just got a letter from the VA regional office in which the following appeared: "As we consider your claim, you may submit evidence showing that your service-connected diabetes mellitus type II have increased in severity." Considering what I've read, this is news to me. I thought it was straight forward that changing from oral meds to insulin along with regulation of activities would be enough to increase my rating from 20 to 40%. Perhaps I should write a letter to them describing the rational for changing to insulin but I am worried that it will not be what they want, whatever that is. Any thought on this?