With the improvement of medical tests and medical treatment, the diagnosis rate of diabetic nephropathy has also increased, in the face of diabetic nephropathy many patients do not know what to do, so that the disease is not effectively controlled, so this small science to take you to learn the “control” and “treatment” of diabetic nephropathy The “control” and “treatment” of diabetic nephropathy. 1, control blood glucose diabetes comprehensive management “five carriage”: diabetes education, nutrition therapy, exercise therapy, blood glucose monitoring, drug therapy. Diabetic patients should learn to use portable blood glucose meters at home for blood glucose testing, including pre-meal, post-meal, bedtime and nighttime blood glucose, and sometimes monitor the blood glucose before and after strenuous exercise, so as to guide diet and exercise, especially to start insulin therapy dose adjustment. Blood glucose control requires a combination of diet, exercise and medication intervention. The principles of choosing hypoglycemic drugs are: when the renal function is normal, most oral hypoglycemic drugs can be applied; when mild or moderate renal insufficiency, insulin (preferred) and drugs with less renal excretion can be chosen according to the situation; patients in end-stage renal failure, especially in the middle and late stages, should stop using oral hypoglycemic drugs and choose insulin therapy. 2, low protein diet Currently advocate diabetic nephropathy patients in addition to diabetic diet, but also low protein diet, to 0.8 g / (kg / day) is appropriate. For patients with existing renal insufficiency, if the endogenous creatinine clearance is >25 ml/min, protein intake should be 0.6 g/(kg/day) with the addition of the essential amino acid α-keto acid. Even if there is obvious edema, still should not give too much protein, which is not only not good for the disease, but also does not help the edema to subside. 3, control blood pressure Diabetic nephropathy patients with hypertension will aggravate urinary albumin excretion by increasing glomerular pressure, accelerating the progression of nephropathy and promoting the deterioration of renal function, hypertension should be effectively controlled, urinary protein <1 g/day should be controlled below 130/80 mm Hg, urinary protein <1 g/day should be controlled below 125/75 mm Hg, for patients with systolic pressure >180 mmHg should be gradually lowered to this standard as tolerated by the patient. The first step should be weight loss through diet or physical exercise and appropriate sodium restriction. For those who still do not reach the target blood pressure, antihypertensive medication should be given. Angiotensin-converting enzyme inhibitors and/or angiotensin II type 1 receptor antagonists are preferred, but attention should be paid to monitoring blood creatinine and blood potassium. In addition to diet adjustment and exercise, statin lipid-lowering drugs are commonly used clinically, which can effectively lower blood cholesterol, and a recent study found that early application of statin drugs can delay the occurrence and development of diabetic nephropathy even in patients with normal blood lipids. Patients with increased triglycerides can use gefiberzil, fenofibrate and other drugs. 5.Replacement therapy Diabetic nephropathy stage V progresses to end-stage renal disease, patients can only rely on renal replacement therapy such as hemodialysis, peritoneal dialysis and kidney transplantation to maintain life. Due to the many complications and early appearance of uremic symptoms in diabetic patients, the indication for dialysis should be relaxed appropriately. Generally, replacement therapy should be started when the endogenous creatinine clearance drops to about 15 ml/min or when it is accompanied by obvious gastrointestinal symptoms. The long-term survival rates of hemodialysis and peritoneal dialysis are similar. The former facilitates glycemic control, has better dialysis adequacy and no protein loss, but cardiovascular and cerebrovascular accidents are likely to occur during dialysis; the latter is convenient and can be performed at home, which can better protect residual renal function, but protein is easily lost, abdominal infection is likely to occur, and the dialysis effect is worse than hemodialysis. For patients with end-stage diabetic nephropathy, kidney transplantation is currently the most effective treatment, accounting for about 20% of kidney transplant patients in the United States. Although kidney transplantation is the most effective treatment, kidney transplantation alone cannot prevent the recurrence of diabetic nephropathy, nor can it improve other diabetic complications, because the above-mentioned hemodialysis and peritoneal dialysis are often not easy to obtain satisfactory results in patients with advanced diabetes, therefore, it is advocated that kidney transplantation should be performed relatively early in patients with diabetic nephropathy, especially renal failure due to type 2 diabetes, and it is not necessary to wait until dialysis Later. The methods of renal replacement therapy have their own advantages and disadvantages, and the appropriate method should be chosen according to the patient’s own situation. In conclusion, diabetes is a lifelong disease that cannot be cured, but can be controlled. When renal complications occur, it is more important to establish confidence, strengthen patients’ own management, scientific diet, and follow medical advice to curb or delay the progression of diabetic nephropathy.