Diabetic nephropathy is characterized by progressive rise in proteinuria. GFR decline, hypertension, and an increased risk of cardiovascular significant morbidity and mortality are all hallmarks of the condition. N-acetylcysteine (NAC) is a powerful antioxidant that efficientily removes a wide range of free radicals generated by oxygen species. NAC can help prevent nephropathy by reducing oxidative cellular damage and enhancing renal vascularization. Several studies have focused on the positive effects of antioxidant medicines such as NAC in decreasing the risk of atherosclerosis and its associated consequences. The object of this study is to see how NAC affects serum lipoprotein a Lp (a) and proteinuria levels in people with type 2 diabetes-induced nephropathy. This trial is a single-center, randomised, prospective, placebo-controlled. The effectiveness of 1200 mg/day of NAC for 60 days in conjunction with conventional therapy for an interventional group is compared to no NAC treatment for the control group in this trial. Comparative data was based on the measurement of specific biomarkers including proteinuria, Lp (a), lipid profile, kidney function test, and blood pressure. NAC significantly reduced proteinuria levels in the experimental group after two months of therapy (P<0.05). However, there was no significant improvement in serum Lp(a) compared to the placebo group (P>0.05). The clinical efficacy of NAC in improving proteinuria levels, systolic blood pressure in diabetic nephropathy patients is superior to that of the control group. NAC had no effect on serum Lp(a) and serum creatinine levels.