William J. Hueston, MD Stephen Scibelli Arch G. Mainous, III, PhD Charleston, South Carolina Submitted, revised, March 5, 2001. From the Medical University of South Carolina. Reprint requests should be addressed to William J. Hueston, MD, Department of Family Medicine, Medical University of South Carolina, PO Box 250192, 295 Calhoun Street, Charleston, SC 29403. E-mail: huestowj@musc.edu.
References
Conclusions
Because physician use of microalbuminuria screening does not follow established guidelines, consideration should be given to other strategies to prevent nephropathy in persons with type 2 diabetes. One proposed strategy would advise all patients with type 2 diabetes to start ACEI or ARB therapy along with their medications for diabetes. This strategy would obviate the need for microalbuminuria screening, while ensuring that patients receive any additional benefits of ACEI or ARB therapy unrelated to renal protection. It is unknown, however, whether patients would accept universal treatment rather than periodic screening. This is an important question that should be addressed before any population-based strategies are adopted.
