Both higher and lower glycaemic levels are associated with adverse outcomes in patients with diabetes mellitus and chronic kidney disease, research has confirmed.
Evidence from a large Canadian clinical trial, including 23, 296 patients with both diabetes and stage 3 and 4 CKD, revealed a U-shaped relationship between HbA1c levels and mortality. The authors found there were increases in the risk of mortality if HbA1c levels were lower than 6.5% or higher than 8%.
The retrospective observational study, published in the Archives of Internal Medicine (http://archinte.ama-assn.org/cgi/content/short/171/21/1920), showed that patients with CKD and HbA1c levels more than 9% had a 35% higher risk of mortality, cardiovascular events, hospitalisation and progression to kidney failure after almost four years follow up.
The authors said they...
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