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

Abstract

Shan-Shan Cui,1 Li-Jun Duan,1 Jun-Feng Li,1 Yong-Zhang Qin,2 Su-Qing Bao,1 Xia Jiang1 1Department of Endocrinology and Metabolism, Tianjin First Central Hospital, Tianjin, People’s Republic of China; 2Department of Endocrinology, First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of ChinaCorrespondence: Shan-Shan CuiDepartment of Endocrinology and Metabolism, Tianjin First Central Hospital, No. 24 of Fukang Road, Nankai District, Tianjin, People’s Republic of ChinaTel [phone]Email [email protected]: This study aims to explore the factors influencing the renal glucose threshold (RTG) 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 RTG. The factors influencing the RTG were then analyzed.Results: The mean RTG in patients with newly diagnosed T2DM was 203.58 ± 55.22 mg/dl. The correlation between the RTG and the various variables was analyzed, and the results demonstrated that the RTG 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 RTG followed in descending order by the 24-hour urine glucose, eGFR, D-dimer, and BMI (P < 0.05).Conclusion: The RTG increases in most patients with newly diagnosed diabetes. The risk factors for the RTG are HbA1c, 24-hour urine glucose, eGFR, D-dimer, and BMI.Keywords: newly diagnosed, type 2 diabetes mellitus, renal glucose threshold, continuous glucose monitoring

Keywords

• newly diagnosed
• type 2 diabetes mellitus
• renal glucose threshold
• continuous glucose monitoring