Association Between HbA1c Levels and Diabetic Nephropathy: A Clinical and Biochemical Assessment

Abstract

Diabetic nephropathy is one of the most common microvascular complications of diabetes mellitus and a major cause of chronic kidney disease worldwide. Persistent hyperglycemia contributes to renal injury through various metabolic, hemodynamic and inflammatory mechanisms. Glycated hemoglobin (HbA1c) reflects average blood glucose levels over approximately two to three months and is widely used to assess long-term glycemic control. Elevated HbA1c levels may be associated with an increased risk of developing diabetic nephropathy. Aim: To evaluate the association between HbA1c levels and diabetic nephropathy and to assess the relationship between glycemic control and renal function parameters. Materials and Methods: A hospital-based observational analytical study is proposed involving patients diagnosed with type 2 diabetes mellitus. Demographic characteristics, duration of diabetes, HbA1c levels, serum creatinine, urinary albumin-to-creatinine ratio (UACR) and estimated Glomerular Filtration Rate (eGFR) are assessed. Patients are categorized according to HbA1c levels and the presence or absence of diabetic nephropathy. Statistical analysis includes descriptive statistics, independent-sample tests, correlation analysis and multivariable logistic regression. Results: In the illustrative dataset, patients with poor glycemic control (HbA1c ≥7%) demonstrate a higher proportion of diabetic nephropathy than patients with HbA1c below 7%. Increasing HbA1c levels are also associated with higher urinary albumin excretion and reduced eGFR. These findings illustrate a possible relationship between inadequate glycemic control and renal impairment. Conclusion: Poor glycemic control, as indicated by elevated HbA1c levels, may be associated with an increased prevalence and severity of diabetic nephropathy. Regular monitoring of HbA1c and renal parameters may help identify patients at increased risk of diabetic kidney disease.