Primary prevention includes early detection of diabetes, glycemic control, screening for microalbuminuria, control of hypertension and smoking cessation, while key issues in secondary prevention are glycemic control, reduction of hypercholesterolemia, control of hypertension, smoking cessation, use of ACE inhibitors and possibly restriction of dietary protein (Walling 2000).There are several pathologic processes that contribute to diabetic nephropathy, including glomerular hypertrophy, sclerosis and nephron loss (Walling 2000).