Key Treatment

To reduce the occurrence and slow the progression of renal disease that begins with microalbuminuria, attain tight glucose and blood pressure control (ADA, 2004, 2005; DCCT, 1995; Lewis et al., 1993; Reichard et al., 1993) (SOR: A).

ACE inhibitors and ARBs have the most favorable outcome data in patients with albuminuria (ADA, 2009; Lewis et al., 1993, 2001; Remuzzi et al., 2006) (SOR: A). In general, ACE inhibitors delay progression of nephropathy in type 1 with hypertension and any degree of albuminuria, and ARBs, in type 2 with renal insufficiency and macroalbuminuria. Both ACE inhibitors and ARBs have shown similar efficacy in type 2 patients with microalbuminuria (Andersen et al., 2000; Brenner et al., 2001; Lindholm et al., 2002; Molitch et al., 2003) (SOR: A).

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