OBJECTIVE: . Aim: This review aims to analyze scientific articles and publications on the role of oxidative stress and xanthine oxidase in the pathogenesis of type 1 diabetes mellitus and diabetic nephropathy in order to update the theories underlying its development and progression. PATIENTS AND METHODS: Materials and Methods: The literature analysis used peer-reviewed articles, reviews, and descriptions of experimental studies from 2021-2024. The study describes the role of oxidative damage in the pathogenesis of diabetic nephropathy and the function of xanthine oxidase as a trigger. CONCLUSION: Conclusions: The study of the molecular mechanisms of the cytoprotective and renoprotective effects of xanthine oxidase inhibition confirms its leading role in the pathogenesis of diabetic nephropathy and opens up new prospects for the development of biomarkers, and therefore new approaches in the diagnosis, treatment, and prevention of diabetes and its dangerous complications.