The Association Between Hemoglobin A1c and Complications Among Individuals With Diabetes and Severe Chronic Kidney Disease
Authors' conclusion
Our data suggest an HbA1c range of 6.7-7.1% (50-54 mmol/mol) to be most favorable for reducing long-term complications in this high-risk population.
Study context
- Population
- Individuals ≥18 years with diabetes and severe chronic kidney disease (CKD) (eGFR <30 mL/min/1.73 m²), Denmark, 2010–2022
- Participants
- 27,113 / 80,131 / 80,797
- Exposure
- Strata of HbA1c levels vs HbA1c 6.3-6.6%
- Severe CKDn = 27,113
- Mild-to-moderate CKDn = 80,131reference
- No-to-mild CKDn = 80,797reference
- Outcome
- Standardized risk of MACE, microvascular complications and hospitalization due to hypoglycemia across HbA1c strata
- Follow-up
- 1 year
Methodological detailsage- and sex-matched reference cohorts, multiple Cox regressions, standardized 1-year risk
- Age- and sex-matched reference cohorts
- Multiple Cox regressions
- Standardized 1-year risk
Main finding
As reported in the abstract
Risk by HbA1c level in severe CKD, vs HbA1c 6.3-6.6% (45-49 mmol/mol)
- Major adverse cardiovascular events (MACE) risk significantly increased at HbA1c ≥7.2% (55 mmol/mol)
- P < 0.01
- MACE risk significantly increased at HbA1c <5.8% (40 mmol/mol)
- P < 0.001
- Microvascular complication risk significantly increased at HbA1c ≥7.2% (55 mmol/mol)
- P < 0.001
- Hypoglycemia hospitalization risk significantly increased at HbA1c ≥6.7% (50 mmol/mol)
- P < 0.001
Observational data: associations, not effects.
Further findings
Association patterns vs matched mild-to-moderate and no-to-mild CKD cohorts
- Association patterns between HbA1c and outcomes similar in severe CKD vs matched cohorts
Original publication
The Association Between Hemoglobin A1c and Complications Among Individuals With Diabetes and Severe Chronic Kidney Disease. Diabetes Care. Published 7 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →