Publication:

Progression of diabetic nephropathy in patients with uncontrolled type 2 diabetes mellitus: a cross-sectional study

Background Diabetic nephropathy (DN) is a major complication of uncontrolled type 2 diabetes mellitus (T2DM), leading to chronic kidney disease (CKD) and end-stage renal disease (ESRD). This study aimed to assess the progression of DN in patients with uncontrolled T2DM and its association with clinical and biochemical parameters.

Methods A cross-sectional study was conducted on 147 T2DM patients aged 45-60 years at Enam medical college, Sir Salimullah medical college, and Dhaka medical college from March 2024 to December 2024. Purposive sampling technique was applied in sample selection Patients were categorized into two groups: poorly controlled diabetes (HbA1c≥7%) and controlled diabetes (HbA1c<7%). Data were analyzed by using SPSS version 23.0 program.

Results This study of 147 T2DM patients found 53.1% had poorly controlled diabetes (HbA1c≥7%), associated with higher urinary ACR, reduced eGFR, and elevated serum creatinine. Advanced CKD (eGFR<60 mL/min/1.73 m2) was present in 67.3%, with 33.3% microalbuminuria and 19.7% macroalbuminuria. Grade 2 hypertension (HTN) (43.5%) was significantly linked to renal impairment, highlighting the need for better glycemic and blood pressure (BP) control.

Conclusions Poor glycemic control and HTN significantly accelerate DN progression in T2DM patients. Early intervention targeting glycemic control, BP management, and regular renal screening is essential to mitigate renal complications and improve outcomes.