DIABETES-MELLITUS - APPLICATION OF AN ANT IHYPERTENSIVE THERAPY

Treating hypertension and microalbuminuria is one of the most importan t tasks next to blood glucose control in the treatment of adolescents with diabetes mellitus type 1. Normoglycemia as well as normotensive b lood pressure values are able to prevent cardiac, vascular and renal c omplications of diabetes. The prevalence of arterial hypertension in p atients with diabetes is considerably higher compared to the general p opulation. The development of diabetic nephropathy is strongly associa ted with arterial hypertension. Diabetic nephropathy can be regarded e ither as cause or result of hypertension. Microalbuminuria, which can be observed already in childhood and adolescence, is the earliest indi cator of progressive renal destruction. One of the most serious compli cations of juvenile diabetes still is terminal renal failure. Recent s tudies demonstrate that familial and genetic factors play an important role in the pathogenesis of diabetic nephropathy. Early identificatio n of patients at risk is warranted. Regular measurement of arterial bl ood pressure and routine urine analysis for albuminuria is a prerequis ite of the care of children and adolescents with diabetes. Early inter vention, especially treatment with ACE inhibitors will improve the pro gnosis for diabetic nephropathy in adolescents with elevated blood pre ssure and/or microalbuminuria.