PROJECT TITLE
Microalbuminutria in normotensive patients with insulin-dependent diabetes mellitus-diet and antihipertensive intervention

Summary
The number of diabetic patients in end-stage reneal feilure has been increasing steadily especially during the last decade. One of every three of four dialized patients is diabetic. Diabetic nephropathy probably is the most important single disorder leading to Renal failure today. Microalbuminuria (MA) is strongly predictive of late hephopathy in Insulin-Dependent Diabetic Mellitus (IDDM) patients. If MA represents the pre-clinical stage of diabetic Nephopathy, an understanding of its nature and pathogenesis is fundamental to development of specific protective therapy. The recognition of this phase of co-called MA is arguably the most important clinical advance in terms of characterizing microvascular function to date, for at this stage the protein leak is responsive to improvement in diabetic control and perhaps tothe manipulation of renal haemodynamics. Improvement as a good metabolic control, antihypertensive therapy with angiotensin converting enzyme (ACE) inhibition and the low protein diet may help retard the progression of renal disease, irrespective of the underlying pathological process. Aim of the study is to compare the effects of low protein diet containing carbohydrate foods with low glycaemic index to these of ACE-inhibitor on the MA in normotensive IDDM patients in case to optimase the intervention. After screening of MA in 1000 IDDM patients they will be randomized to one of four study groups: I group - on intensive insulin therapy (IIT); II group - on IIT+ACE inhibitor; III group - IIT+low protein diet; IV group - IIT+placebo; The following parameters at every 6 months for 3 years will be measured: global glucose, HbA1, Lipid profiles, creatinine clearance, MA, Natriuria, glomerular fi

Key words
microalbuminuria, dibetes mellitus, low protein diet, ace inhibitor