Rates of Incident Type 2 Diabetes in Chronic Kidney Disease

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Type 2 diabetes was associated with a family history of diabetes and increased fasting blood glucose levels.
Type 2 diabetes was associated with a family history of diabetes and increased fasting blood glucose levels.

Rates of type 2 diabetes (T2D) are significantly higher in individuals with chronic kidney disease (CKD) compared with the general population, according to a study published in the American Journal of Kidney Disease.

This prospective cohort study included 1713 participants with CKD who did not have a diagnosis of T2D at study commencement but did present with reduced glomerular filtration rates. Institutional review boards at participating clinical centers approved the study.

Of the 1713 participants, researchers categorized 81.8% as normoglycemic and 18.2% as prediabetic at baseline. At 6.65 years, 11.85% of participants developed T2D. 

Among individuals with baseline fasting blood glucose levels lower than 100mg/dL, the rate increased to 12.17% (116 events over 9530 person-years); among individuals with fasting blood glucose levels between 100 and 125 mg/dL, the rate increased to 46.55% (87 events over 1,869 person-years). Unadjusted links between kidney function and damage in relation to T2D were insignificant. In multivariable models, T2D had strong associations with fasting blood glucose level (P =.002) and family history of diabetes (P =.03).

Researchers conclude that the rate of T2D in people with CKD is significantly higher when compared with the general population, which supports the necessity of increased vigilance in those with CKD. Limitations of this analysis pointed out by the authors include “the relatively low number of events observed which diminished the power of all analyses.”

Reference

Jepson C, Hsu JY, Fischer MJ, et al. Incident type 2 diabetes among individuals with CKD: findings from the chronic renal insufficiency cohort (CRIC) study [published online August 31, 2018]. Am J Kidney Dis. doi:10.1053/j.ajkd.2018.06.017

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