Answer: B. Annual assessment of urinary albumin is recommended for patients who have had type 1 diabetes for ≥5 years and in all patients with type 2 diabetes. Either an ACE inhibitor or an ARB is suggested for the treatment of nonpregnant patients with modestly elevated urinary albumin excretion (30 to 299 mg/d) and is recommended for those with urinary albumin excretion >300 mg/d. Per the 2015 American Diabetes Association Standards of Medical Care, the terms “microalbuminuria” (30 to 299 mg/d) and “macroalbuminuria” (>300 mg/d) are no longer the recommended terminology, since albuminuria occurs on a continuum. Albuminuria is defined as a urine albumin-to-creatinine ratio ≥30 mg/g. Consider referral to a nephrologist when there is uncertainty about the etiology of kidney disease, difficult management issues, or advanced kidney disease.

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