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The goals of treatment are to slow the progression of kidney damage and control related complications.
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The main treatment, once proteinuria is established, is angiotensin converting enzyme (ACE) inhibitors. This class of drugs reduces urine protein levels and slows the progression of diabetic nephropathy. Many studies have shown that related drugs, angiotensin receptor blockers (ARBs), have a similar benefit. In fact, a combination may be best.
Blood-glucose levels should be closely monitored and controlled. This may slow the progression of the disorder, especially in the very early ("microalbuminuria") stages.
Medications to manage diabetes include hypoglycemic pills and insulin injections. Your blood glucose must be monitored and the dose of insulin adjusted as needed. As kidney failure progresses, less insulin is excreted, so smaller doses may be needed to control glucose levels.
The diet may be modified (see diet for diabetics) to help control blood-sugar levels.
High blood pressure should be aggressively treated with antihypertensive medications. Uncontrolled high blood pressure will worsen kidney, eye, and blood vessel damage in the body. Controlling your high blood pressure is the most effective way of slowing kidney damage from diabetic nephropathy. It is also very important to control lipid levels, maintain a healthy weight, and engage in regular physical activity.
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