Back to Ask the Diabetes Team Ask the Diabetes Team

From Washington, DC, USA:

I am a 23 years old and have had diabetes for 17 years. I have always been under good control with the exception of a few highs here and there. (My last Hemoglobin A1c was 5.4%). I am very nervous about developing complications and tend to be extremely cautious when it comes to my health.

My boyfriend, a medical student, and I keep very well informed about research advancements and improved treatments for typeá1 diabetes. After talking with several nephrologists and doing some research, we have become increasingly convinced that taking a low dose ACE inhibitor might help reduce my chances of developing kidney problems in the future. I am concerned that I may not be able to find a doctor willing to pursue this approach. How should I proceed, and would this be a reasonable course of action?


You raise a very important question. This is one we beat around a lot on rounds and in the clinic. There is clearly good data to support the use of ACE inhibitors in individuals with diabetes who have macro- or microalbuminuria.

Unfortunately, there is not data to demonstrate the benefit of ACE inhibitors prior to the development of microalbuminuria. In the absence of hypertension, I do not use ACE inhibitors when individuals are in the normal range for albumin excretion. We do not know if there is a linear relationship to kidney function and ACE inhibitor use which extends into the normal albumin excretion period. However, there will soon be information to make your decision as several clinical trials are underway worldwide to try and answer this question. The other side of the question is that there may not be a benefit, and there are side effects and monitoring associated with ACE inhibitors.


Original posting 11 Feb 2001
Posted to Complications


  Back to Ask the Diabetes Team Return to the Top of This Page

Last Updated: Tuesday April 06, 2010 15:09:18
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.

This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents. Our mission is to provide education and support to families living with type 1 diabetes.
By using this site, you agree to our Terms of Use, Legal Notice, and Privacy Policy.
© Children with Diabetes, Inc. 1995-2018. Comments and Feedback.