Patients with even mild hypertension or persistent microalbuminuria should consult a physician about the use of antihypertensive medicines. Low-Protein Diets A diet containing reduced amounts of protein may benefit people with kidney disease of diabetes. In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that most patients with stage III or stage IV nephropathy consume moderate amounts of protein. A third treatment, known as intensive management or glycemic control, has shown great promise for people with IDDM, especially for those with early stages of nephropathy.
Intensive management is a treatment regimen that aims to keep blood glucose levels close to normal.
The regimen includes frequently testing blood sugar, administering insulin on the basis of food intake and exercise, following a diet and exercise plan, and frequently consulting a health care team. A number of studies have pointed to the beneficial effects of intensive management. In the Minnesota Medical School trial, researchers examined kidney tissues of long-term diabetics who received healthy kidney transplants. After 5 years, patients who followed an intensive regimen developed significantly fewer lesions in their glomeruli than did patients not following an intensive regimen. When people with diabetes reach ESRD, they must undergo either dialysis or a kidney transplant.