A third of all Type 1 diabetic patients will develop proteinuria as a clinical sign of diabetic nephropathy. A 100-fold increase in relative mortality is observed in patients with persistent proteinuria. Proteinuria is preceded by a microproteinuric phase, which is reversible upon optimized metabolic control. Thereby, progression towards clinically manifest nephropathy can be delayed. Macroproteinuria and progressive renal insufficiency are not influenced by metabolic control, but by aggressive antihypertensive therapy.
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