HbA1c’s Role in eGFR Variations Among Young Diabetics: Insights from South Indian CKD Study

Abstract

Diabetes Mellitus (DM) is a leading cause of chronic kidney disease (CKD) worldwide, yet its prevalence among younger adults remains underexplored. This study aimed to investigate the relationship between HbA1c levels and kidney function, measured by eGFR, in young diabetic patients (20-40 years). A total of 191 participants were included, consisting of 107 males (56%) and 84 females (44%). HbA1c > 6.5% was measured using the immunoturbidimetric method on the Mindray BS-600 machine, and eGFR was calculated via the Cockcroft-Gault equation. Other parameters, such as fasting and postprandial glucose, urea, creatinine, and blood urea nitrogen (BUN), were also assessed.

The study found a negative correlation between HbA1c and eGFR, particularly in females (p = -0.126), suggesting a link between higher HbA1c and reduced kidney function. Females exhibited a higher prevalence of Stage 3 CKD (25%) compared to males (7%). Our findings revealed a decline in eGFR correlated with elevated HbA1c, suggesting early diabetic nephropathy linked to poor glycemic control. Males showed slightly elevated creatinine levels (1.07 mg/dL), indicating early kidney impairment. The correlation between HbA1c and BUN was weak but notable, with p-values of 0.10 in males and 0.20 in females, suggesting impaired kidney function.

In conclusion, females had higher HbA1c levels (9.3 ± 1.94) than males (9.26 ± 1.99) and a greater prevalence of Stage 3 CKD, with eGFR decline linked to poor glycemic control. These findings underscore the need for early intervention in managing diabetes to prevent kidney impairment.