Which ACE inhibitor is best for diabetic nephropathy?

Captopril is the only FDA-approved ACE inhibitor for diabetic nephropathy although other ACE inhibitors may be as effective. Several studies demonstrated that lisinopril is effective in the reducing urinary albumin excretion in diabetes[2].

When do diabetics need ACE inhibitors?

In nonpregnant patients with diabetes and hypertension, either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) is recommended for those with a modestly elevated urinary albumin-to-creatinine ratio (30-299 mg/g creatinine) and is strongly recommended for those with a urinary …

Why are ACE inhibitors used for diabetic nephropathy?

Angiotensin II induces several fibrogenic chemokines, namely monocyte chemoattractant protein-1 (MCP-1) and transforming growth factor-β. The progression of diabetic nephropathy can be retarded by ACE inhibitors (ACEIs) in patients with type 1 and type 2 diabetes.

Should all diabetics be on ACE?

Angiotensin-converting enzyme (ACE) inhibitors are recommended for all patients with type 1 diabetes and microalbuminuria, regardless of blood pressure (1). These recommendations are based on well-conducted clinical trials (2), but several questions remain unanswered.

Do statins help with diabetes?

Statins are cholesterol-lowering drugs that are frequently used as part of diabetes care due to the knowledge that people with diabetes face a greater likelihood of heart attack and stroke.

Are there any new ADA recommendations for diabetic nephropathy?

Per the ADA update, clinicians should consider prescribing a SGLT2 inhibitor in type 2 diabetes patients with diabetic nephropathy.

What are the American Diabetes Association ( ADA ) standards?

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care.

What should you do if you have diabetic nephropathy?

Approach Considerations Several issues are key in the medical care of patients with diabetic nephropathy. [20, 21] These include glycemic control, management of hypertension, and reducing dietary salt intake and phosphorus and potassium restriction in advanced cases.

How often does type 2 diabetic develop nephropathy?

About 20–30% of patients with type 1 or type 2 diabetes develop evidence of nephropathy, but in type 2 diabetes, a considerably smaller fraction of these progress to ESRD. However, because of the much greater prevalence of type 2 diabetes, such patients constitute over half of those diabetic patients currently starting on dialysis.