The authors present partial results of a prospective study conducted in 65 insulin-dependent diabetics with varying duration of disease in whom development of micro-angiopathic organ alterations is followed in relation to diabetes compensation and development of clinically manifest proteinuria or to albumin excretion (microalbuminuria). The results suggest that the increase in albumin excretion in recent-onset and non-recent-onset patients is in most cases only an expression of changes in renal function due to metabolism and therapy and apparently of little value in predicting the risk of developing diabetic nephropathy. The situation is not so unambiguous in patients with long duration of diabetes and, in case increased albumin excretion remains unchanged or further increases despite intensive insulin therapy, it may serve most likely as a marker of high risk of developing diabetic nephropathy.

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