Risk factors for progression to albuminuria in individuals with newly diagnosed type 2 diabetes: a 5-year cohort study.

BACKGROUND

This study aimed to determine the 5-year incidence of albuminuria in Chinese individuals with newly diagnosed type 2 diabetes mellitus (T2DM) and identify baseline risk factors for progression to albuminuria.

METHODS

An observational cohort study was conducted with 604 individuals aged ≥ 18 years diagnosed with T2DM between January 2014 and December 2017 at a tertiary hospital in China, followed through November 2022. The cumulative incidence of progression from normoalbuminuria to albuminuria was assessed. Risk factors for progression were evaluated using multiple logistic regression.

RESULTS

Of the 368 individuals with normoalbuminuria at diagnosis, the mean (SD) age was 54 (11) years. The 5-year cumulative incidence of progression to albuminuria was 7.9%. Higher urine albumin-to-creatinine ratio (UACR) (OR 1.18; 95% CI, 1.10-1.26) and higher homeostasis model assessment of insulin resistance (HOMA-IR) (OR 1.18; 95% CI, 1.15-1.32) at diagnosis were independently associated with progression. After adjusting for baseline UACR, higher HOMA-IR at diagnosis was linked to a more rapid increase in UACR over time.

CONCLUSION

Early screening for UACR and management of insulin resistance in individuals with T2DM may help delay the onset of microalbuminuria.