The Factors Influencing the Renal Glucose Threshold in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Shan-Shan Cui; Li-Jun Duan; Jun-Feng Li; Yong-Zhang Qin; Su-Qing Bao; Xia Jiang

doi:10.2147/DMSO.S336791

The Factors Influencing the Renal Glucose Threshold in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Diabetes Metab Syndr Obes. 2021 Nov 9:14:4497-4503. doi: 10.2147/DMSO.S336791. eCollection 2021.

Authors

Shan-Shan Cui¹, Li-Jun Duan¹, Jun-Feng Li¹, Yong-Zhang Qin², Su-Qing Bao¹, Xia Jiang¹

Affiliations

¹ Department of Endocrinology and Metabolism, Tianjin First Central Hospital, Tianjin, People's Republic of China.
² Department of Endocrinology, First Affiliated Hospital of Gannan Medical University, Ganzhou, People's Republic of China.

Abstract

Objective: This study aims to explore the factors influencing the renal glucose threshold (RT_G) in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Methods: A cross-sectional study was conducted on 1009 hospitalized patients with T2DM using stratified random sampling. Blood glucose was monitored using a dynamic blood glucose monitor to obtain the mean blood glucose (MBG), which is used to calculate the RT_G. The factors influencing the RT_G were then analyzed.

Results: The mean RT_G in patients with newly diagnosed T2DM was 203.58 ± 55.22 mg/dl. The correlation between the RT_G and the various variables was analyzed, and the results demonstrated that the RT_G was correlated with the patient's age (r = -0.14539, P = 0.0001); MBG (r = -0.35009, P = 0.0001); renal long neck (r = 0.16762, P = 0.0001); homeostatic model assessment for insulin resistance (r = -0.38322, P = 0.0001); homeostatic model assessment for beta-cell function (r = -0.22770, P = 0.0001); and the levels of glycated hemoglobin (HbA1c; r = 0.98994, P = 0.0001), blood urea nitrogen (r = -0.11093, P = 0.0004), creatinine (r = -0.26414, P = 0.0001), uric acid (r = -0.20149, P = 0.0001), total cholesterol (r = 0.13192, P = 0.0001), low-density lipoprotein (r = 0.12466, P = 0.0001), thyroid-stimulating hormone (r = -0.06346, P = 0.0460), beta-2 microglobulin (r = -0.08884, P = 0.0056), and 24-hour urine glucose (r = 0.32115, P = 0.0001). Multiple linear stepwise regression analysis revealed that the HbA1c, 24-hour urine glucose, estimated glomerular filtration rate (eGFR), D-dimer, and body mass index (BMI) should be included in the final model, and HbA1c had the greatest impact on the RT_G followed in descending order by the 24-hour urine glucose, eGFR, D-dimer, and BMI (P < 0.05).

Conclusion: The RT_G increases in most patients with newly diagnosed diabetes. The risk factors for the RT_G are HbA1c, 24-hour urine glucose, eGFR, D-dimer, and BMI.

Keywords: continuous glucose monitoring; newly diagnosed; renal glucose threshold; type 2 diabetes mellitus.

Grants and funding

National Natural Science Foundation of China (NO. 82000763); Spring project of Tianjin First Central Hospital (NO.2019CF20); Spring project of Tianjin First Central Hospital (NO.CF201824).