Diabetic nephropathy (Type I diabetics, secondary prev.)
- hypertension in type I diabetics is often an indication of diabetic nephropathy
- in type I diabetics blood pressure reduction and ACE inhibitors slow the rate of decline of renal function in overt diabetic nephropathy; also they delay the progression from microalbuminuric phase to overt nephropathy
- ACE inhibition should be titrated to the maximum dose tolerated and recommended
- the target blood pressure is described in the menu item
- combination therapy is invariably required to achieve blood pressure targets
- even in the presence of a normal blood pressure Type I diabetics with persistent microalbuminuria or proteinuria may also benefit from ACE-inhibition titrated to the recommended maximum dose
- in the presence of frank proteinuria, in addition to BP control with ACE inhibitors; some suggest protein intake should be reduced to <0.6 g/kg body weight/day
- measures should also be taken to alter other risk factors such as smoking, obesity and dyslipidaemia
Related pages
Create an account to add page annotations
Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page