IMPACT OF DIABETES MANAGEMENT ON THE PROGRESSION OF DIABETIC KIDNEY DISEASE

Abstract

Introduction
Diabetic kidney disease (DKD) is a serious complication of diabetes mellitus (DM) and remains a leading cause of end-stage renal disease (ESRD) worldwide. This prospective cohort study aims to examine the effect of diabetes management on the progression of DKD.

Methods

This study was designed as a prospective cohort study, involving 200 patients diagnosed with DKD. Patients were divided into well-controlled (HbA1c < 7%) and poorly controlled (HbA1c ≥ 7%) groups. The estimated glomerular filtration rate (eGFR), serum creatinine, and urinary albumin-to-creatinine ratio (uACR) were recorded at baseline and during each monthly follow-up appointment throughout the 12-month study period.  

Results

Patients having HbA1c less than 7% (n = 72) showed slower decline of estimated glomerular filtration rate (eGFR, 2.1 ± 0.9 mL/min/1.73 m²). Pearson’s correlation analysis demonstrated a strong inverse association between HbA1c levels and eGFR (r = -0.72, p < 0.001). Patients with HbA1c levels greater than 7% experienced a major increase in uACR measurements from 280 mg/g to 620 mg/g. The change in uACR was smaller for patients with HbA1c values less than 7%, whose uACR levels decreased from 240 mg/g to 370 mg/g (p = 0.004).  

Conclusion
This study provides strong evidence that diabetes management slows kidney function decline and decreases the risk of DKD progression.