Intensive blood sugar controls progression of kidney damage in diabetics: JAMA

Timely blood glucose management is critical for avoiding diabetic kidney disease, and intensive vs routine glycemic control may not be linked with higher protection against the development of existing diabetic kidney disease. End-stage kidney disease (ESKD) is becoming more common across the world, and diabetes is the primary cause of ESKD.

Lowering blood glucose levels in diabetic individuals is linked to a lower incidence of diabetic kidney damage.

The optimal glycemic control goal in diabetic renal disease is unknown. Hae Hyuk Jung conducted this study with the goal of exploring optimum on-treatment glycemic levels related with delaying the course of diabetic kidney damage.

The outcomes of this study were published in The Journal of the American Medical Association.

From 2005 to 2019, this retrospective cohort analysis used countrywide Korean cohorts from the National Health Information Database. Adults with diabetes using anti hyperglycemic medications with and without chronic kidney disease (CKD) were included in the study, who were identified via a countrywide health screening survey performed from 2009 to 2010. The data was studied from October 2020 to March 2021. The main outcome was a combination of serum creatinine doubling, end-stage renal disease, or death from CKD.

A fasting blood glucose level of 126 mg/dL to less than 160 mg/dL among individuals with albuminuria was associated with a lower risk of the composite outcome of serum creatinine doubling, end-stage kidney disease, or death from chronic kidney disease in this cohort study of 183 049 adults with diabetes using anti hyperglycemic agents. A fasting blood glucose level of 100 mg/dL to less than 126 mg/dL was linked with a lower risk of the composite outcome, and a level of less than 140 mg/dL was associated with a lower risk of new-onset albuminuria in people with no albuminuria.

In conclusion, Diabetes and CKD patients require a personalized and thorough approach to treatment. Nonetheless, strict glycemic management may be associated with lower overall health risks in CKD patients, particularly those with minimal albuminuria.

Reference:

Jung, H. H. (2021). Evaluation of Serum Glucose and Kidney Disease Progression Among Patients With Diabetes. JAMA Network Open, 4(9), e2127387. https://doi.org/10.1001/jamanetworkopen.2021.27387