Diabetic nephropathy rarely develops before 10 years’ duration of type 1 DM (previously known as insulin-dependent diabetes mellitus IDDM). Approximately 3% of newly diagnosed patients with type 2 DM (previously known as non–insulin-dependent diabetes mellitus NIDDM) have overt nephropathy. The peak incidence (3%/y) is usually found in persons who have had diabetes for 10-20 years, after which the rate progressively declines. The risk for the development of diabetic nephropathy is low in a normoalbuminuric patient with diabetes’ duration of greater than 30 years. Patients who have no proteinuria after 20-25 years have a risk of developing overt renal disease of only approximately 1% per year.