IgA nephropathy is the most frequent glomerular disease. There are no disease-specific therapies for IgA nephropathy and the established treatment approach for most patients is to apply supportive measures that include the use of RAAS and more recently SGLT2i. Man, born in 1948, with a history of diabetes since 2005 and ischemic cardiomyopathy. Since then, treated with insulin degludec, empagliflozin and metformin. UAC and eGFR levels are within limits. In January 2020, the patient reported the appearance of purpura on the lower limbs and the abdomen and a dermatologic evaluation was obtained. He underwent a skin biopsy which showed leukocytoclastic vasculitis. ASA gets substituted by clopidogrel with an immediate spontaneous resolution of the purpura (UACR 20 mg/g crea, GFR 90 ml/min/1.73 m2). In September 2020, the patient’s tests showed UACR 1817 mg/g and GFR 80 ml/min/1.73 m2. A nephrological consultation was performed. Both abdomen ultrasound and renal artery doppler ultrasonography results were negative, but proteinuria increased to 3.7 g/24 hours. Ramipril 2.5 mg/day was prescribed confirming the diagnosis of proteinuria in diabetes. In the following months, the patient developed progressively invalidating arthromyalgia. Proteinuria was 3.15 g/24 hours (Tab. I) and a new nephrology consultance advised to perform a renal biopsy. Histological analysis confirmed a glomerulonephritis with mesangial IgA deposits and previous purpura points to ongoing glomerulonephritis of Henoch-Shoenlein vasculitis. An increase in ramipril to 5 mg/day was recommended together with tight blood pressure control. Proteinuria decreased to 1.2 g/24 hours. In order to maximize renal protective treatment, especially in terms of albuminuria reduction, dulaglutide was added stopping insulina. Proteinuria further decreased during a follow-up visit in May 2022 (0.42 g/24 hours) and UACR decreased too (150 mg/g crea). The effect on proteinuria was persistent in November 2022 (proteinuria 0.4 g/24 hours) and UACR decreased more (47 mg/g crea). The presence of diabetes may have delayed the correct diagnosis at first and later turned out to be an opportunity to maximize antiproteinuric treatment and possibly better long-term outcome.