To the Editor: Lewis et al. (Nov. 11 issue)1 report that captopril was beneficial in patients with diabetic nephropathy. We have several questions. Since base-line urinary protein excretion was significantly lower in the captopril group, is it possible that the less severe nephropathy in this group accounted for its slower progression? Does the recommendation that angiotensin-converting-enzyme inhibitors be given to patients with diabetic nephropathy mean that these agents should be given in preference to diuretics and beta-adrenergic antagonists? The latter two types of drugs may have more side effects, but they are the only drugs that have been proved effective.
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