Diabetic nephropathy is one of the chronic microvascular complications of diabetes mellitus. Once a patient is diagnosed with diabetes, kidney damage has already occurred, which will not cause any uncomfortable symptoms at first and can be easily ignored until there is obvious proteinuria and edema before going to a specialist, then it is too late. So, how can diabetic patients keep away from kidney damage? I. Prevention of diabetes, away from kidney damage Diabetes is the direct cause of diabetic nephropathy, and the occurrence of diabetes is closely related to excessive caloric intake, excess nutrition, obesity, lack of exercise and other factors, from the following two aspects of prevention of diabetes, is the first step away from kidney damage. 1, healthy diet, “three low and one high”: strictly control the intake of high-calorie food fried, pan-fried and baked, and develop the “three low and one high” diet of low salt, low sugar, low fat and high fiber. Eat fresh vegetables, fruits and grains and cereals, and don’t eat too much refined rice and flour. Tomatoes, cucumbers, wheat bran cake high fiber content. Properly limit protein intake, protein intake to 0.8g / (kgd) – 1.0 g / (kgd) is appropriate, high-quality protein is better, such as milk, eggs, lean meat, aquatic products, etc.. Excessive intake of salt and protein may increase the kidney load and should not be ignored. Some people work, life is stressful, with food “treat” themselves more undesirable. 2, adjust the lifestyle: quit smoking and alcohol, life should be regular, combined with work and rest, every day to carry out moderate physical exercise. Physical exercise can promote insulin secretion, increase insulin sensitivity, consumption of muscle glycogen, accelerate lipolysis, improve blood circulation, and help reduce weight. It is recommended to exercise 3 or 4 times a week, no less than 30 minutes each time, the intensity should be appropriate, should be done 1 hour-2 hours after meals, aerobic exercise methods such as walking, walking, jogging, climbing stairs, playing tai chi, swimming, cycling, dancing, playing badminton, etc. are preferred. Anaerobic exercise is strength training for specific muscles, which can increase lactic acid in the blood, leading to shortness of breath and muscle pain, such as weight lifting, 100-meter race, etc. Such exercise is not advocated. Once suffering from diabetes, the following measures should be recognized 1. blood sugar control to meet the standard: Patients diagnosed with diabetes often ask why there are complications of diabetes. It is now believed that failure to meet blood glucose control targets is the main cause of complications. The United Kingdom Prospective Diabetes Study (UKPDS) showed that good glycemic control halved the incidence of type 1 diabetic nephropathy and reduced the incidence of type 2 diabetic nephropathy by one-third. The glycosylated hemoglobin A1c (GHbA1c) ratio reflects the average blood glucose level 1 to 2 months prior to measurement and is an important indicator of good diabetes control. 2011 WHO recommended glycosylated hemoglobin A1c ≥ 6.5% as one of the diagnostic criteria for diabetes. Evidence suggests that the risk of complications increases as the glycosylated hemoglobin ratio increases, while the risk of complications decreases as the glycosylated hemoglobin ratio decreases. Therefore, ideal control of blood glucose is essential. How should we do this? Early detection and diagnosis are necessary to achieve the standard of blood glucose control. Regular monitoring of both fasting blood glucose and postprandial blood glucose is the key. It should be noted that routine health checkup laboratory tests only measure fasting blood glucose and not postprandial blood glucose, which is easy to miss the diagnosis. As long as the diagnostic criteria for diabetes are met, a clear diagnosis can be made and timely interventions should be made to reduce the occurrence of diabetic nephropathy. The 2010 edition of China’s Type 2 Diabetes Prevention and Control Guidelines points out that the target of fasting blood glucose control for diabetic patients is 3.9-7.2 mmol/L, and the target of non-fasting blood glucose control is ≤10 mmol/L; the target of glycated hemoglobin control is less than 7%; the standard of blood glucose control for critically ill patients is 7.8-10 mmol/L. 2. Blood pressure and blood lipids should not be ignored: Many patients may ask “We diabetic patients, good control of blood sugar is definitely a must, but why should we pay strict attention to blood pressure and blood lipids?” High blood pressure and high blood lipids can increase the risk of diabetes complications, especially diabetic nephropathy. Controlling blood pressure and lipids is effective in reducing cardiovascular risk in patients with diabetes, and monitoring and controlling them to meet standards is just as important as monitoring and controlling blood glucose to meet standards. Controlling blood pressure to standard can reduce protein in urine, and delaying the production of proteinuria can reduce protein damage to the glomerulus, which plays an important role in protecting kidney function. When renal impairment occurs, the importance of blood pressure reduction even exceeds that of blood glucose control. The goal of blood pressure lowering: ≤130/80mmHg (1mmHg=0.133kPa) for general population, ≤140/90 mmHg for the elderly. if the patient has proteinuria greater than 1g/d, try to control blood pressure below 125/75mmHg, if proteinuria is less than 1g/d, control blood pressure below 130/80mmHg, for systolic blood pressure >180mmHg Patients should slowly and gradually lower their blood pressure to this standard. The main antihypertensive drugs are angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists, and it is important to monitor blood pressure regularly to avoid low or fluctuating blood pressure. Aggressive intervention in people with diabetes mellitus with hypertension can effectively prevent macrovascular and microvascular complications of diabetes mellitus. Elevated blood lipids, also a risk factor for diabetic nephropathy, is most basically controlled by diet, eating less fatty foods, avoiding overeating, and eating more vegetables and fruits with low sugar content. Commonly used lipid-lowering drugs include statins and fibrates, and the target values for lipid control in diabetic patients in China are: LDL cholesterol <2.5 mmol/L, HDL cholesterol >1.0 mmol/L, total cholesterol <4.5 mmol/L and triglycerides <1.5 mmol/L. If the patient has cardiovascular disease, it is more important to closely monitor lipids and blood pressure to make them to meet the standards. Patients with diabetes should have their lipids (including LDL-C, total cholesterol, triacylglycerols (triglycerides) and HDL-C) checked at least once a year. Those on lipid-regulating medications should also be evaluated periodically for efficacy and side effects after administration. Blood pressure should be measured at each patient visit. Patients with hypertension should be instructed to self-monitor and record their blood pressure daily at home. In conclusion, the most important thing to prevent diabetic nephropathy is effective control of blood glucose and alloglycemic hemoglobin (below 7.0%); appropriate restriction of protein intake (generally 0.8-1.0 g/day/kg, below 0.8 g/day/kg after the development of proteinuria); active control of lipids in combined hyperlipidemia; active control of blood pressure in combined hypertension (below 130/80 mmHg), which can be recommended Apply ACEI and/or ARB. improve lifestyle habits, exercise appropriately, control body weight, smokers should quit smoking, eat reasonably, and monitor blood and urine indicators regularly. It should be noted that some diabetic patients can have glomerulonephritis at the same time, and the treatment at this time is completely different from diabetic nephropathy. Therefore, diabetic patients with proteinuria should go to a nephrology specialist for an early diagnosis and early treatment.