50 % of all patients with type 1 DM and PDR and > 10 years duration have concomitant proteinuria
Measurement of the albumin-to-creatinine ratio in a random spot collection OR 2) 24-h collection with creatinine, allowing the simultaneous measurement of creatinine clearance; and OR 3) timed (e.g., 4-h or overnight) collection .
In the Kumamoto Study, a reduction in the conversion from micro- to macroalbuminuria was observed with intensive treatment
It often is considered that the clinical expression of diabetic neuropathy is the tip of the iceberg. Patients presenting with symptoms, particularly numbness and pain, represent only a small percentage of patients with neuropathy. Clinical examination may detect asymptomatic neuropathy in another 30% of patients. Further sophisticated testing, including quantitative sensory testing and electrophysiologic testing, such as nerve conduction velocity, might pick up abnormalities in another 30% to 40% of patients who cannot be detected on clinical examination, but such testing is rarely, if ever, done in clinical practice on asymptomatic patients. The clinician usually can differentiate the symptoms of neuropathy from other symptoms based on the pattern of complaints and physical findings. Occasionally, electrophysiologic testing may be required.
