Albuminuria is an early manifestation of diabetic nephropathy
and is associated with risk factors including
hypertension, impaired glycaemic control, and hyperlipidaemia
[4]. It is also an early sign of microvascular
disease in diabetes [5] and is associated with an increased
risk of cardiovascular disease (CVD) [6]. Using albuminuria
as inclusion criteria meant that this group was at much
higher risk of cardiovascular events (equivalent to existing
coronary disease) [5] and improving metabolic control without harmful side effects is important. Improved
metabolic control through improved diet and weight loss
could prevent the progression of micro and macrovascular
disease. High protein weight loss diets are commonly used,
but concern has been raised about using this diet in diabetics
due to the potential for a deleterious effect on renal
function [7] as well as potential adverse effects on LDL
cholesterol if saturated fat is not reduced.