Type 2 Diabetes has become the most frequent cause of End-stage renal failure (ESRF) in diabetic patients. The majority of patients with type 2 diabetes and renal failure suffer from diabetic glomerulosclerosis, but nondiabetic renal disease and atypical presentations, e.g. as irreversible acute renal failure or ischaemic nephropathy, play an increasingly important role.

Known risk factors for the onset of Diabetic Nephropathy include (1) genetic predisposition (indicated by a history of hypertension and cardiovascular events in first-degree relatives), (2) quality of glycemic control, (3) level of blood pressure, and (4) smoking. At the time when type 2 Diabetes is diagnosed, an abnormal blood pressure profile is found in approximately 80%. In patients with established diabetic nephropathy, hypertension is the most important factor which promotes progression, and this is susceptible to intervention. Although, at least in principle, diabetic nephropathy is a preventable condition, currently only a minority of type 2 diabetic patients receives adequate medical treatment to prevent onset or progression of diabetic nephropathy.

　　The five stages of type 2 Diabetes are the following:

　　First stage - the main manifestations in this stage are as follows:  the kidneys are enlarged by about 25% by ultrasound evaluation. Glomerular filtration rate (GFR) is increased, about more than 120ml/m, or even 150 ml/m. The biopsy of renal tissue is normal, and the blood pressure is also in the normal range. All the symptoms can return to normal if the blood sugar is well controlled.

　　Second stage - the discharge of urine albumin is normal but the glomerulus has appeared structural changes. The Urinary Albumin Excretion Rate is normal, <20μg/min or <30mg/24h. After physical activity, it may increase but return to normal after rest. Glomerular capillary basement membrane thickens and mesangial matrix increases. GFR generally is a little higher than the normal and usually to compensate for elevated blood sugars >150mL/min. The glycolated hemoglobin (HbA1c) is >9.5%. When GFR >150mL/min, UAER >30μg/min, it is easier for the disease develop into Diabetic Nephropathy. In the first two stages, most patients have normal blood pressure, their GFR may increase but UAER is normal, so thus two stages are not considered as diabetic nephropathy.

　　Third stage - also called the early stage of Diabetic Nephropathy. Urinary Albumin Excretion Rate is 20～200μg/min, the blood pressure gradually increases, and there is irreversible glomerular cell injury.

　　Fourth stage - clinical Diabetic Nephropathy or Dominant Diabetic Nephropathy. The main characteristics are large amount of albuminuria, >3.5g per day, severe edema, and hypertension.

　　Fifth stage - end stage of renal failure (ESRF, ESRD). Due to the thickening of glomerular basement membrane, and the stenosis of glomerular blood capillary, and the death of more glomerulus, the renal functions will gradually deteriorate and finally develop into renal failure.

　　Stem Cell Transplant in the treatment of Diabetes

　　Many patients are chronically ill from type 2 diabetes and are interested in finding new methods to reverse the renal impairment associated with diabetes.. Stem cells are a kind of multipotent cells. Under certain conditions, they can differentiate into various cells so they can be used in many diseases. Diabetes is a very good example of a diseases which we believe can be treated with Stem Cell Transplant.  Due to the damage of the pancreas, islet β cells which can secrete insulin, there is deficiency of insulin, and the blood sugar will continuously rise.  Stem Cells can repair the damaged pancreas islet β cells and recover the functions of pancreas islet to induce it to secrete insulin in a normal fashion. If type 2 Diabetes is treated early enough with stem cell transplant therapy, it may not lead to irreversible diabetic nephropathy.