Fasting glucose variability as a risk indicator for end‐stage kidney disease in patients with diabetes: A nationwide population‐based study

Da Young Lee, Jaeyoung Kim, Sanghyun Park, So Young Park, Ji Hee Yu, Ji A. Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Kyungdo Han, Nan Hee Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Given the fact that diabetes remains a leading cause of end‐stage kidney disease (ESKD), multi‐aspect approaches anticipating the risk for ESKD and timely correction are crucial. We inves-tigated whether fasting glucose variability (FGV) could anticipate the development of ESKD and identify the population prone to the harmful effects of GV. We included 777,192 Koreans with diabetes who had undergone health examinations more than three times in 2005–2010. We evaluated the risk of the first diagnosis of ESKD until 2017, according to the quartile of variability independent of the mean (VIM) of FG using multivariate‐adjusted Cox proportional hazards analyses. During the 8‐year follow‐up, a total of 7290 incidents of ESKD were found. Subjects in the FG VIM quartile 4 had a 27% higher risk for ESKD compared to quartile 1, with adjustment for cardiovascular risk factors and the characteristics of diabetes. This effect was more distinct in patients aged <65 years; those with a long duration of diabetes; the presence of hypertension or dyslipidemia; and prescribed angiotensin‐converting enzyme inhibitors, metformin, sulfonylurea, α‐glucosidase inhibitors, and insulin. In contrast, the relationship between baseline FG status and ESKD risk showed a U‐shaped association. FGV is an independent risk factor for kidney failure regardless of FG.

Original languageEnglish
Article number5948
JournalJournal of Clinical Medicine
Volume10
Issue number24
DOIs
Publication statusPublished - 2021 Dec 2
Externally publishedYes

Keywords

  • Diabetes mellitus
  • End‐stage kidney disease
  • Glucose variability
  • Korean National Health Insurance Corporation

ASJC Scopus subject areas

  • Medicine(all)

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