Diabetes Health Center

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If you have nephropathy and are pregnant or are planning to become pregnant, talk with your doctor about which medicines you can take. You may not be able to take some medicines (for example, angiotensin-converting enzyme [ACE] inhibitors, such as captopril, lisinopril, ramipril, or enalapril) during pregnancy, because they may harm your developing baby.

Prevention

Prevention is the best way to avoid kidney damage from diabetic nephropathy.

• Keep your blood sugar levels within a target range. Manage your blood sugar by eating a balanced diet, taking your medicines (insulin or oral medicines), and getting regular exercise. The American Diabetes Association recommends that you keep your blood sugar levels at:¹
  • 70 mg/dL to 130 mg/dL before meals and 110 mg/dL to 150 mg/dL at bedtime.
  • Less than 180 mg/dL 1 to 2 hours after meals.
  Your doctor will want you to check your blood sugar several times each day. For more information, see:

  Diabetes: Checking Your Blood Sugar.

• Have yearly testing for protein in your urine.
  • If you have type 1 diabetes, begin urine tests for protein after you have had diabetes for 5 years.
  • Children with type 1 diabetes should begin yearly urine protein screening when they are 10 years of age and have had diabetes for 5 years.
  • If you have type 2 diabetes, begin screening at the time diabetes is diagnosed.
• Keep your blood pressure at less than 130/80 mm Hg with medicine, diet, and exercise. Learn to check your blood pressure at home. For more information, see:

  Chronic Kidney Disease: Changing Your Diet.

  High Blood Pressure: Checking Your Blood Pressure at Home.

• Stay at a healthy weight. This can help you prevent other diseases, such as high blood pressure and heart disease. For more information, see the topic Weight Management.
• Follow the nutrition guidelines for hypertension (including the Dietary Approaches to Stop Hypertension, or DASH, diet). For more information, see:

  High Blood Pressure: Using the DASH Diet.

• Do not smoke or use other tobacco products. For more information, see the topic Quitting Smoking.

If you already have diabetic nephropathy, you may be able to slow the progression of kidney damage by:

• Avoiding dehydration by promptly treating other conditions-such as diarrhea, vomiting, or fever-that can cause it. Be especially careful during hot weather or when you exercise.
• Reducing your risk of heart disease. Lifestyle changes such as eating a low-fat diet, quitting smoking , and getting regular exercise can help reduce your overall risk of developing heart disease and stroke. For more information, see the topics Healthy Eating, Fitness, and Quitting Smoking.
• Treating other conditions that may block the normal flow of urine out of the kidneys, such as kidney stones, an enlarged prostate, or bladder problems.
• Not using medicines that may be harmful to your kidneys, especially nonsteroidal anti-inflammatory drugs (NSAIDs). Be sure that your doctor knows about all prescription, nonprescription, and herbal medicines you are taking.
• Avoiding X-ray tests that require IV contrast material, such as angiograms, intravenous pyelography (IVP), and some CT scans. IV contrast can cause further kidney damage. If you do need to have these types of tests, make sure your doctor knows that you have diabetic nephropathy.
• Avoiding situations where you risk losing large amounts of blood, such as unnecessary surgeries. Do not donate blood or plasma.
• Lowering your blood pressure, because high blood pressure can make kidney damage even worse.
• Checking with your doctor to find out if it is safe for you to drink alcohol. If you do drink alcohol, have no more than 1 drink a day. Limiting alcohol can lower your blood pressure and lower your risk of kidney damage.