Clinical Development of Treatment Direction for Diabetic Nephropathy as Diet and Pharmacotherapy

The American Diabetes Association (ADA) announced the Standard of Care (SoC)-2025 in January 2025. It included useful information about the low-carbohydrate diet (LCD), chronic kidney disease (CKD), and Metformin. Historically, the ADA has re-evaluated LCD in 2008, 2011, 2013, and 2019. Authors have developed LCD medically and socially through the Japan LCD Promotion Association (JLCDPA). From the latest report of post hoc analysis, Metformin may have a beneficial effect on CKD cases with an eGFR of less than 30 ml/min/1.73 m². For diabetic nephropathy (DN), impressive findings have been observed for major adverse cardiovascular events (MACE) and major adverse kidney events (MAKE).