Impact of Glycemic Burden on Renal Filtration Decline and Proteinuria in Type 1 Diabetes Mellitus
https://doi.org/10.15605/jafes.041.S1
- Author:
Sian Lin Toh
1
;
Chee Keong See
2
;
Wei Hong Chin
3
Author Information
1. Hospital Bentong
2. Hospital Sultan Haji Ahmad Shah
3. Universiti Malaya
- Publication Type:Journal Article
- MeSH:
Diabetes Mellitus, Type 1;
Proteinuria
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):39-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Diabetic nephropathy is a major complication of type 1
diabetes mellitus (T1DM) and a leading cause of endstage renal disease. This study aims to correlate long-term
glycemic control and disease duration with renal decline,
measured via estimated glomerular filtration rate (eGFR)
and urinalysis proteinuria.
Methodology:A retrospective cohort study was conducted among 15
patients with T1DM at Hospital Bentong. Independent
variables were 3-year mean glycated hemoglobin A1c
(HbA1c) and duration of diabetes. Dependent variables
included the change in eGFR derived from baseline and
latest serum creatinine (calculated using the CKD-EPI 2021
equation), and the shift in urine protein severity, mapped
to an ordinal scale, over a 3-year follow-up. Multivariate
linear regression and Spearman’s rank correlation were
utilized for analysis.
Results:The cohort consisted of 5 male patients and 10 female
patients with a mean initial presentation HbA1c of 11.4%, a
mean 3-year HbA1c of 9.15%, and a median disease duration
of 11 years. Baseline eGFR was preserved (mean 117.15 mL/
min/1.73 m²). Regression analysis revealed that for every 1%
increase in mean HbA1c, eGFR declined significantly by 9.6
mL/min/1.73 m² (p = 0.002). Furthermore, each additional
year of disease duration independently reduced eGFR by
1.1 units (p = 0.008). Spearman validation confirmed the
strong negative correlation between HbA1c and eGFR (Rho
= -0.664, p = 0.006). Conversely, the correlation between
3-year mean HbA1c and worsening proteinuria was not
statistically significant (Rho = -0.067, p = 0.827), and patient
gender did not significantly impact progression (p = 0.129).
Conclusion:Poor long-term glycemic control and longer duration of
diabetes mellitus are strong independent predictors of
decline in functional glomerular filtration in T1DM. While
worsening proteinuria may not be detected during a short
3-year window using a standard urinalysis (UFEME), a
more sensitive test such as Urine Albumin-to-Creatinine
Ratio may better detect early structural kidney damage.
- Full text:2026072908540660625EP_A037.pdf
