When should diabetic patients be prescribed ACE inhibitors or ARBs?

Diabetic patients should be prescribed ACE inhibitors or ARBs primarily when they exhibit microalbuminuria. This is because these medications help to protect kidney function and slow the progression of diabetic nephropathy by reducing intraglomerular pressure, thereby reducing proteinuria. Microalbuminuria serves as an early sign of diabetic kidney disease, and the initiation of ACE inhibitors or ARBs in this stage can significantly improve outcomes.

While other conditions, such as neuropathy, nephropathy, and retinopathy, are important in the management of diabetes and its complications, the critical moment for intervention with ACE inhibitors or ARBs is when microalbuminuria is detected. Treating at this stage can prevent further kidney damage and reduce the likelihood of progressing to more severe stages of nephropathy.