A 41-year-old obese male presented with rapid weight gain (7kg in one week) associated with bilateral oedema to the knees. He had nephrotic range proteinuria of 9 grams per day with impaired kidney function, serum creatinine 176umol/L. He was diagnosed with Type II Diabetes Mellitus (HbA1C 12.1%) and renal biopsy confirmed class III diabetic nephropathy with nodular glomeurlosclerosis. of developing renal failure, cardiovascular morbidity and mortality.