dGlucose is linked to renal function changes in diabetes

This study examines if dglucose, two-hour postprandial (2 hPP) minus fasting glucose (F), predicts glycemic control better than F or 2 hPPglucose.

F and 2 hPPglucose, and renal function variables; BUN, serum creatinine (Scr), and estimated GFR (eGFR), were obtained from 56 insulin treated diabetic adults. 2 hPP-F(d) was calculated. Variables were compared when 2 hPPglucose was <200 (n=23) or >200 mg/dL (n=33). Correlation coefficients were calculated for F, 2 hPP or 2 hPP-F(d) renal function variables versus those for glucose.

Variables differed significantly between F and 2 hPP (t-test, p<0.05) for all patients and when 2 hPPglucose was < or >200 mg/dL, except dBUN at <200 mg/dL. When F, 2 hPP or 2 hPP-F(d) variables between 2 hPPglucose< and >200 mg/dL were compared, dScr was significant (p=0.0327). Correlation coefficients between dglucose and dScr or deGFR, were significant for all patients (r=0.420, p=0.0013, and r=-0.434, p=0.0008, respectively) and for 2 hPPglucose >200 mg/dL (r=0.523, p=0.0018 and r=-0.513, p=0.0023, respectively) but not 2 hPPglucose <200 mg/dL. When dglucose increased by 100 mg/dL, dScr increased by 0.08 and 0.11 mg/dL, and deGFR decreased by 2.73 and 3.73 mL/min for all patients and >200 mg/dL, respectively.

dGlucose better predicts renal function changes than F or 2 hPPglucose. Postprandial hyperglycemia (<200 mg/dL) control is crucial for renal protection in diabetes.