Estimated glucose disposal rate may predict Renal Decline in T2DM Patients
A research study by Dr Juan Peng and colleagues has concluded that type 2 diabetes mellitus (T2DM patients) with estimated glucose disposal rate or eGDR <6.34 mg/kg/min had a high risk of rapid eGFR decline, eGFR<60 mL/min/1.73m2 or the composite renal outcomes. Compared to eGDR 5.65∼6.91 mg/kg/min, eGDR >8.33 mg/kg/min decreased the risk of rapid eGFR decline by 75%, eGFR<60 mL/min/1.73m2 by 60%, and the composite renal outcome by 61%, they mentioned.
Insulin resistance is a feature of T2DM The eGDR is a validated marker for insulin resistance. It is tied to diabetic complications. Data on the relationship between eGDR and renal outcomes in T2DM patients is scarce.
In the present study, researchers investigated the value of eGDR in predicting renal progression in T2DM. This study is published in Journal of the Endocrine Society.
The study could be summarised as follows:
- Researchers enrolled 956 T2DM patients.
- These patients had baseline eGFR of ≥60 mL/min/1.73m2 and a 5-year follow-up.
- Rapid eGFR decline, eGFR <60 mL/min/1.73m2, and composite renal endpoint consisting of 50% eGFR decline, doubling of serum creatinine, or end-stage renal disease were the primary outcomes measured.
- eGFR decline was experienced by 23.95% of patients.
- 21.97% had eGFR <60 mL/min/1.73m2.
- There were 12.13% of patients with the composite renal endpoint.
- eGDR presented a relationship with follow-up eGFR and a per cent change in eGFR.
- eGDR <6.34 mg/kg/min was an independent risk factor for rapid eGFR decline, eGFR<60 mL/min/1.73m2or the composite renal endpoint.
- Compared with eGDR of 5.65∼6.91 mg/kg/min, eGDR levels >8.33 mg/kg/min decreased the risk of rapid eGFR decline by 75%, eGFR<60 mL/min/1.73m2 by 60%, and the composite renal endpoint by 61%.
- eGDR was associated with primary outcomes as shown in Subgroup analysis performed by sex, age, and diabetes duration
They said, “Lower eGDR is a predictive factor for renal deterioration in T2DM patients.”
Further reading:
https://academic.oup.com/jes/advance-article/doi/10.1210/jendso/bvad069/7188163
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