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Re: [IP] Ace inhibitors

    I'll spare the "old-timers" replaying my 17 yr old daughter's saga , but 
suffice it to say that being on an ACE inhibitor decreased the massive 
amounts of protein she began shedding only 3 yrs ago ( 5 yrs post-dx) by 
almost 90%!!! Since it's difficult to know WHICH 40% of the diabetic 
population will get that complication, there are indeed some endos & A LOT of 
nephrologists who believe all diabetics should be on an ACE inhibitor 
prophyllactically to stave off an erodsion of the kidney's "basement 
membrane" die to hyperfiltration. Other beg to differ saying, that would mean 
giving a medication unnecessarily to 60% of all diabetics. My personal 
resolution: make sure you're having a 24 hr urine collection annually (NOT a 
dipstick since my daughter's a.m. dipstick was always normal, but her 24 hr 
was astoudningly high) to confirm that you're not past 30 mgs, which is the 
bottom range (30-300) for micralbuminuria. Melissa's bp by the way was 90/60 
pre-Vasotec ( and she takes 10 mg daily) & has remained in that range. ONLY 
issue she has had is that in very hot weather, she MUST drink a lot of water.
   Hope this info helps....but don't be surprised at the # of endos/docs who 
will look at you like you're crazy if you broach this subject because this is 
relatively "new" info. The old "rule of thumb" was that complications didn't 
show up for 15-20 years, by which time the kidneys were no longer functioning 
at full capacity! The nephrologists will tell you that no one saw 
complications until then, because that's when the patients" presented" with 
symptoms & no one had thought to look for earlier indications such as 
excessive proteinuria as a precursor.

Regards, Renee (Melissa's pump-mom/advocate)
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