Diabetic nephropathy is a disease of diabetic patients due to disorders of glucose metabolism, resulting in microangiopathy that causes glomerulonephritis, a predominantly tubular sclerosis. It has a high incidence and is one of the most important causes of death in diabetic patients. The lesions of diabetic nephropathy are likely to be present in the early stages of diabetes, but they are usually asymptomatic and not easily detected in the early stages. In some cases, there may be increased urinary microalbumin excretion, which is evident after exercise. This condition can persist for several years. If treated effectively, these lesions can return to normal in the short term. However, if not treated carefully, the condition can deteriorate rapidly. The typical clinical manifestations of diabetic nephropathy tend to appear many years after the onset of diabetes. The initial symptom in most patients is intermittent proteinuria, which may also have leukocytes and tubular patterns in the urine, often in response to exertion, infection, and poorly controlled diabetes mellitus. When proteinuria is detected, the glomerular filtration rate may be normal or may already show decreases. Later, the glomerular filtration rate decreases more rapidly, statistically by about 1% per month. Therefore, it may enter the stage of renal failure after 6-7 years. At this stage patients may also develop the following symptoms: 1. Nephrotic syndrome: Patients may show typical symptoms such as massive proteinuria, swelling and hypoproteinemia. The appearance of these symptoms generally indicates that the lesion has reached an advanced stage and the patient feels significantly fatigued and weak. If the renal function deteriorates, anemia and hypertension are seen, and the lesion is progressive and rarely remits. 2, hypertension: patients can appear moderately high blood pressure, in the presence of nephrotic syndrome, combined with more hypertension, may be related to glomerular vascular sclerosis. 3, other diabetic manifestations: When patients have typical diabetic nephropathy, they are usually accompanied by cardiovascular lesions, retinal and peripheral neuropathy. When there is diabetic nephropathy, due to the reduction of glomerular filtration, the total amount of glucose in the filtrate is reduced and can be completely or mostly reabsorbed by the renal tubules, so that there can be high blood glucose and normal urine glucose or blood glucose and urine glucose measurements do not match and are out of proportion. In this case, we cannot rely on the urine glucose value to adjust the insulin dosage, but should adjust the medication according to the blood glucose value.