Diabetes mellitus affects in excess of 285 million people worldwide and this number is predicted to increase to 439 million by 2030. A major complication of diabetes is kidney disease termed diabetic nephropathy (DN). This is the leading cause of end sage renal failure (ESRF) in the developed world. DN has a well-defined natural history of progressive leakage of albumin into the urine (albuminuria). Damage to both glomerular endothelial cells and podocytes are an important part of the disease. Increasing evidence suggests that glomerular endothelial cell dysfunction, including glycocalyx disruption, contributes to the development or microalbuminuria early in disease development.