Thirty percent of insulin-dependent diabetics develop a nephropathy which, when left untreated, leads within a few years to terminal renal failure with its considerable human and financial consequences. Antihypertensive drugs constitute the most effective means of slowing down the deterioration of glomerular filtration. Terminal renal failure and its cardiovascular complications can really be prevented provided the patient is treated at the early stage of incipient diabetic nephropathy. During the last few years, various therapeutic measures have been suggested with very promising short- and medium-term results. The dream of a true prevention of diabetic nephropathy will become a reality when the results of well-controlled clinical trials with prolonged follow-up will be available.