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Discuss the use of ACE and Angiotensin 2 receptor blockers in diabetic nephropathy. Is there a role for a double blockade? What is diabetic nephropathy? Diabetic nephropathy can be defined as a microvascular complication of diabetes marked by albuminuria and a deteriorating course from normal renal function to end-stage renal disease (ESRD). Diabetes is a disease which is caused by the inadequate production of insulin by the body or by the body not being able to properly use the insulin that is produced thereby resulting in hyperglycaemia. The high glucose and other abnormalities of diabetes may lead to kidney damage known as diabetic nephropathy. There are two main types of diabetes, type I, which is insulin dependent, and type II, which is non-insulin dependent. Type 2 diabetes is characterised by insulin resistance, i.e., the failure to respond to normal concentrations of insulin1. Type 1 diabetes is when the body no longer makes...

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