Effective blood sugar control forms the cornerstone of diabetic nephropathy treatment. Maintaining blood pressure at target levels is critically important in reducing the risk and slowing the progression of diabetic nephropathy. Restricting dietary salt intake facilitates blood pressure control and lowers the risk of cardiovascular disease. In cases where the albumin/creatinine ratio consistently remains high, even in the absence of hypertension, antihypertensive drugs from the ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB) class are used to delay the progression of chronic kidney disease.

For advanced-stage diabetic nephropathy or kidney failure, approaches such as dialysis, kidney transplantation, and symptomatic management are applied.