Microvascular Complications

• Reduction of protein intake to 0.8 to 1.0 g/kg body wt/day in individuals with diabetes and the earlier stages of CKD and to 0.8 g/kg body wt/day in the later stages of CKD may improve measures of renal function (urine albumin excretion rate, glomerular filtration rate) and is recommended. (B)
• MNT that favorably affects cardiovascular risk factors may also have a favorable effect on microvascular complications such as retinopathy and nephropathy. (C)

• Target A1C is as close to normal as possible without significant hypoglycemia. (B)
• For patients with diabetes at risk for cardiovascular disease, diets high in fruits, vegetables, whole grains, and nuts may reduce the risk. (C)
• For patients with diabetes and symptomatic heart failure, dietary sodium intake of <2,000 mg/day may reduce symptoms. (C)
• In normotensive and hypertensive individuals, a reduced sodium intake (e.g., 2,300 mg/day) with a diet high in fruits, vegetables, and low-fat dairy products lowers blood pressure. (A)
• In most individuals, a modest amount of weight loss beneficially affects blood pressure. (C)