In a study conducted in an American Diabetes Association centre, Brunisholz et al. [32] demonstrated that DSME provided by certified diabetes educators including a registered nurse or dietitian could significantly ameliorate the various components of diabetes care bundle including HbA1c level (below 8.0%), low-density lipoprotein level (below 100 mg/dL), blood pressure (below 140/90 mmHg), nephropathy screening or prescription of angiotensin receptor or angiotensin converting enzyme blocker, and retinal eye exam. This evidence concerns the gene ACE and kidney disorder.