This protocol addresses diabetic nephropathy occurring in patients with type 1 diabetes mellitus (T1DM) who also have chronic kidney disease (CKD). The coexistence of these two conditions shapes both the therapeutic goals and the specific approach to glycaemic management.
In T1DM, glycaemic control depends on insulin therapy. The presence of CKD introduces additional considerations, as declining renal function can influence how insulin is handled by the body, requiring careful monitoring and adjustment of the treatment approach.
Management centres on glycaemic control through basal insulin therapy. The specific insulin strategy and dosing must account for the stage and progression of CKD — the full protocol details the recommended approach, including how to adapt treatment as kidney function changes.
The primary clinical target is an HbA1c below 7% on an individualised basis. The complete regimen, including how targets may be further refined depending on the patient's profile, is available via the link below.