With the development of society and changes in lifestyle, the incidence of diabetes has increased significantly. In 2007, there were about 246 million people with diabetes worldwide, and the number is expected to reach 380 million by 2025. Diabetes has become a major public health problem that threatens human health and can cause a variety of complications throughout the body, including diabetes involving the kidneys is diabetic nephropathy. Once the kidney function is impaired in diabetes, its nephropathy progresses much faster than in other kidney disease patients. According to the statistics of the United States, Japan and many European countries, diabetic nephropathy has risen to the first cause of uremia. In China, diabetic nephropathy is the second leading cause of chronic renal failure. Moreover, once diabetic nephropathy progresses to the late stage, its treatment is far more difficult than other kidney diseases. Therefore, it is advocated that diabetic nephropathy should be prevented and treated as early as possible. Clinically, diabetic nephropathy is divided into five stages. However, stage 1 and 2 diabetic nephropathy, which simply shows hypertrophy of the kidney, increased glomerular filtration rate and thickened glomerular basement membrane, is clinically difficult to diagnose. At least stage 3 diabetic nephropathy is diagnosed clinically when it can be clearly diagnosed. The first three stages are the early stages of diabetic nephropathy, which is the best time to slow down the development of the disease, and can stabilize or even reverse the disease if treated effectively. Once a large amount of proteinuria appears, it enters stage 4, the clinical diabetic nephropathy stage, at which time the progression of nephropathy can only be slowed down, but not stopped. For diabetic nephropathy, it is necessary to focus on active and proactive prevention in the early stage, and powerful treatment should be given in the middle stage. For late stage diabetic nephropathy, although clinically effective treatment can be given, it is helpless and sometimes tricky. The key to diabetic nephropathy is to prevent and treat it at an early stage. So, how can we do early detection and early treatment of diabetic nephropathy? It can be done in different stages of the disease from the following aspects. For early detection and diagnosis of diabetic nephropathy, all type 1 diabetic patients should have regular urine routine, urine protein, β2-microglobulin and kidney function, and pay attention to measuring blood pressure and doing fundus examination more than 5 years after diagnosis. When available, urine microalbumin measurement should be done; urine microalbumin is more sensitive. If an increase in urine microalbumin is found, it should be measured 3 times in a row within 3 to 6 months to determine if it is persistent microalbuminuria. If microalbumin increases in the urine, it indicates that diabetes has caused nephropathy. In patients with type 2 diabetes, urine microalbumin should be measured at the time of diagnosis. If it is normal, urine and other tests should be performed regularly during subsequent treatment to detect diabetic nephropathy early. For patients diagnosed with diabetic nephropathy, attention should be paid to the following aspects: 1. Strict control of blood glucose: You cannot just be satisfied with having received glucose-lowering treatment, but must control blood glucose at the ideal level. Glycosylated hemoglobin is a commonly used indicator to reflect the level of blood sugar control, and the target value should be less than 6.5%, fasting blood sugar 4.4-6.7mmol/L, 2 hours after meal blood sugar 7.8
mmol/L or less. Choose the appropriate glucose-lowering treatment plan under the guidance of the doctor. When kidney damage is serious, choose drugs more carefully, such as avoiding the use of metformin to prevent lactic acidosis. 2, control hypertension: diabetic nephropathy is often combined with hypertension, hypertension will accelerate the development of diabetic nephropathy, two effective antihypertensive treatment can significantly slow down the development of nephropathy and reduce urinary albumin excretion. The blood pressure of diabetic patients should be controlled below 130/80mmHg, and if the patient is combined with proteinuria, it is better to control the blood pressure below 120/75mmHg. You can choose antihypertensive drugs that can protect the function of the kidneys, such as Prilosec or Satan drugs. 3, limit protein intake: When you have diabetic nephropathy, reducing the intake of protein food can reduce the burden on the kidneys and slow down the development of nephropathy. Moderate intake of high-quality protein is the best choice, not only can not increase the burden on the kidneys, but also can meet the body’s protein needs. You can choose animal protein such as eggs, milk, lean meat and fish, and avoid animal offal, egg yolk and fish roe. When there is obvious swelling or accompanied by hypertension, limit salt intake and control water intake. 4, control lipid: fat metabolism disorder will aggravate the degree of kidney damage, and in turn kidney damage can be complicated by the manifestation of fat metabolism disorder, timely regulation of blood lipid, the prevention and treatment of diabetic nephropathy is of great significance. Adhere to a low-fat diet, can apply drugs to triglycerides, cholesterol are as normal as possible to control. 5, develop good habits, non-smoking, appropriate exercise, maintain a calm, happy mood: In short, early diagnosis and early control of diabetes is the basis for preventing the occurrence of diabetic nephropathy, regular monitoring, timely detection of microalbuminuria is an important sign of early diagnosis and reversal of diabetic nephropathy, lasting and good control of blood sugar is the key to prevent the development of diabetic nephropathy, active control of hypertension is Protecting the kidney and stopping the development of diabetic nephropathy is an important factor, and scientific diet runs through the prevention and treatment of diabetic nephropathy.