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Relationship Between Glycemic Indices and eGFR Values Among Type 2 Diabetes Mellitus Individuals With Chronic Kidney

K Vaishali1, Chandana Acharya2, Shobha U Kamath3

  • 1Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Clinical Medicine Insights. Endocrinology and Diabetes
|November 5, 2025
PubMed
Abstract

Insights

For type 2 diabetes (T2DM) patients with chronic kidney disease (CKD), HbA1c is vital for long-term glucose control. Fructosamine offers complementary insights, especially in advanced CKD, aiding timely treatment adjustments.

Area of Science:

  • Endocrinology
  • Nephrology
  • Clinical Chemistry

Background:

  • Type 2 diabetes (T2DM) significantly contributes to chronic kidney disease (CKD), cardiovascular disease, and mortality.
  • Glycosylation discrepancies in T2DM patients with CKD are critical for disease causation and progression.
  • Effective management requires understanding these discrepancies and their impact on renal function.

Purpose of the Study:

  • To evaluate HbA1c and fructosamine as predictors of declining renal function in T2DM patients.
  • To compare the correlation of HbA1c and fructosamine with estimated glomerular filtration rate (eGFR) across CKD stages 1-5.
  • To determine the utility of these markers in managing T2DM in the context of CKD.

Main Methods:

  • Study included 424 adult T2DM patients diagnosed per ADA guidelines with CKD stages 1-5.
  • Measured HbA1c and fructosamine levels for all participants.
  • Analyzed correlations between HbA1c, fructosamine, and eGFR across different CKD stages.

Main Results:

  • A weak positive correlation was observed between HbA1c and eGFR in CKD stages 1-4.
  • A weak negative correlation was found between fructosamine and eGFR in CKD stages 1-4.
  • HbA1c interpretation can be challenging in later CKD stages.

Conclusions:

  • HbA1c is a reliable tool for long-term glucose management and kidney disease progression forecasting in T2DM.
  • Fructosamine provides valuable short-term glycemic insights, particularly useful in advanced CKD.
  • Combining HbA1c and fructosamine offers optimal diabetes management, enabling prompt medication adjustments and long-term risk assessment.
Keywords:
CKDHbA1cT2DMcorrelationeGFRfructosamineglycated hemoglobin

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