Comprehensive risk factor control and its biomarker‐mediated association with diabetic microvascular complications
Authors' conclusion
In this apparently healthy T2D population, comprehensive risk factor control is associated with a substantially lower incidence of DMCs and longer DMC-free survival, effects partly mediated through improvements in inflammatory, metabolic, and hepatic biomarkers.
Study context
- Population
- Early-stage T2D with preserved kidney function and no prior cardiovascular or microvascular disease, UK Biobank; mean age 59.26 years, 61.08% men
- Participants
- 11,083 participants
- Exposure
- Optimal risk factor control vs lesser control
- Outcome
- DMCs (severe or clinically overt, from hospital inpatient and death records) and DMC-free survival
- Follow-up
- Median 11.26 years
Methodological detailsUK Biobank, mediation analysis
- UK Biobank
- Mediation analysis
Main finding
As reported in the abstract
DMCs
Hazard ratio (95% CI)
Optimal control
0.55(0.41–0.76)
- Optimal control
- additional DMC-free survival from age 45 5.51 years (95% CI 3.10–7.91)
- Developed diabetic microvascular complications (DMCs) (all participants)
- 1716 (15.48%)
Observational data: associations, not effects.
Further findings
Biomarker mediation
- Inflammation (leukocytes, monocyte and neutrophil counts, C-reactive protein), liver function (gamma-glutamyltransferase) and energy metabolism (glycoprotein acetyls) biomarkers significantly mediated the associations; proportion explained
- 1.79%-30.31%
Original publication
Comprehensive risk factor control and its biomarker‐mediated association with diabetic microvascular complications. Diabetes Obes Metab. Published 25 December 2025. doi:10.
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