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Without intervention, 20–40 percent of patients with type 2 diabetes/microalbuminuria, will evolve to macroalbuminuria. [53] Diabetic nephropathy is the most common cause of end-stage kidney disease , [ 13 ] [ 14 ] which may require hemodialysis or even kidney transplantation . [ 15 ]
Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine, in other words, when an abnormally high permeability for albumin in the glomerulus of the kidney occurs.
Albuminuria is a pathological condition wherein the protein albumin is abnormally present in the urine (>30 mg per day). It is a type of proteinuria.Albumin is a major plasma protein (normally circulating in the blood); in healthy people, only trace amounts of it are present in urine, whereas larger amounts occur in the urine of patients with kidney disease.
A diet high in plant fibre was recommended by James Anderson. [34] This may be understood as continuation of the work of Denis Burkitt and Hugh Trowell on dietary fibre, [35] which may be understood as a continuation of the work of Price. [36] It is still recommended that people with diabetes consume a diet that is high in dietary fiber.
Usually, people are recommended to control diet, exercise, and maintain a healthy weight, although some people may need medications to control their blood sugar levels. Other goals of diabetes management are to prevent or treat complications that can result from the disease itself and from its treatment. [3]
In the early days of insulin treatment for type 1 diabetes there was much debate as to whether strict control of hyperglycaemia would delay or prevent the long-term complications of diabetes. The work of Pirart [ 50 ] suggested that microvascular complications of diabetes were less likely to occur in individuals with better glycaemic control.
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