Evidence mapPaperPMID 41403408Full record

ArticleFrontiers in clinical diabetes and healthcare2025

The effect of HbA1C variability on the development and progression of diabetic nephropathy.

Alper Coskun, Aslihan Calim, Emre Sedar Saygili, Tamer Sakaci, Feyza Yener Ozturk, Yener Koc, Fatih Borlu, Yuksel Altuntas, Taner Basturk

Abstract read
In one paragraph

Article in Frontiers in clinical diabetes and healthcare, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Leveraging Machine Learning to Assess Post-COVID-19 Glycemic Control in Diabetic Patients.International journal of environmental research and public health · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alper CoskunDepartment of Internal Medicine, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Aslihan CalimDepartment of Internal Medicine, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Emre Sedar SaygiliDepartment of Endocrinology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Tamer SakaciDepartment of Nephrology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Feyza Yener OzturkDepartment of Endocrinology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Yener KocDepartment of Nephrology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Fatih BorluDepartment of Internal Medicine, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Yuksel AltuntasDepartment of Endocrinology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Taner BasturkDepartment of Nephrology, University of Health Sciences, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Diabetes mellitus (DM) is a prevalent chronic disease that can lead to severe microvascular complications. Among these, diabetic nephropathy (DN) remains a leading cause of end-stage renal disease worldwide. Glycemic variability, reflecting fluctuations in blood glucose, has been suggested as a potential predictor of DM complications. This study aimed to investigate whether visit-to-visit HbA1c variability contributes to the development and progression of DN in patients with DM. Methods: In this retrospective cohort study, 228 patients were selected from 2,000 individuals diagnosed with DM between January 2007 and December 2017. A total of 80 patients without DN at baseline (ODN) and 148 patients with DN at baseline (WDN) were included in the study. HbA1c was measured 2-4 times per year over 3-5 years. Mean, standard deviation (SD), and coefficient of variation (CV) of HbA1c were calculated. Annual urea, creatinine, and albumin/protein levels were recorded. Logistic regression identified independent risk factors. Results: DN developed in 47 (58.8%) patients in the ODN group, whereas progression occurred in 44 (29.7%) patients in the WDN group. In the ODN group, higher HbA1c mean, SD, CV, hypertension, and albuminuria were significantly associated with DN onset (p<0.05). Logistic regression analysis confirmed HbA1c variability and hypertension as independent predictors. No significant association was found between HbA1c variability and DN progression. Conclusions: Variability in HbA1c is linked to the onset of DN but not its progression. These findings highlight the need for strategies targeting glycemic stability in DM management. Larger, multicenter prospective studies are warranted to confirm these results.

Indexed as

albuminuriadiabetic nephropathyHbA1cHbA1c variabilityproteinuria

Identifiers

PMID41403408
PMCPMC12702771

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.