Insertion-deletion (I/D) of a 287-bp fragment at intron 16 of the ACE gene results in the genotypes II, ID and DD.[19] Polymorphism was thought to affect ACE-mediated physiological functions[20] and to cause differences in plasma ACE expression levels.[21] Conflicting findings in different populations on the relationship between ACE I/D gene polymorphism and diabetic nephropathy led us to investigate ACE I/D gene polymorphism as a risk factor for the development of diabetic nephropathy in the multiethnic Malaysian population. Here, ACE is linked to diabetic kidney disease.