Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes

Diabetic kidney disease is traditionally regarded as a complication of chronic hyperglycaemia associated with diabetes. However, the relationship between glycaemic thresholds and the development of diabetic kidney disease is increasingly questioned. We present a case of a 69-year-old woman with prog...

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Main Authors: Nirmay Sonar, Jarvis Pennington, Mishell Siles Borda, Zaynah Sadiq, Matthew Beasey, Sathiyendram Poobalasingham
Format: Article
Language:English
Published: SMC MEDIA SRL 2025-07-01
Series:European Journal of Case Reports in Internal Medicine
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Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/5378
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author Nirmay Sonar
Jarvis Pennington
Mishell Siles Borda
Zaynah Sadiq
Matthew Beasey
Sathiyendram Poobalasingham
author_facet Nirmay Sonar
Jarvis Pennington
Mishell Siles Borda
Zaynah Sadiq
Matthew Beasey
Sathiyendram Poobalasingham
author_sort Nirmay Sonar
collection DOAJ
description Diabetic kidney disease is traditionally regarded as a complication of chronic hyperglycaemia associated with diabetes. However, the relationship between glycaemic thresholds and the development of diabetic kidney disease is increasingly questioned. We present a case of a 69-year-old woman with progressive renal dysfunction and biopsy findings suggestive of diabetic kidney disease, despite repeatedly normal glycosylated haemoglobin (haemoglobin A1c) and without a clinical diagnosis of diabetes or pre-diabetes. This case highlights the limitations of current haemoglobin A1c thresholds and raises the question of whether diabetic kidney disease can truly develop in the absence of diabetes. Stricter glycaemic criteria may help identify at-risk patients earlier and prevent renal complications.
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issn 2284-2594
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publishDate 2025-07-01
publisher SMC MEDIA SRL
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series European Journal of Case Reports in Internal Medicine
spelling doaj-art-01ddc0f5685840b893f7e48a4fe811b62025-08-20T02:56:43ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-07-0110.12890/2025_0053784913Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetesNirmay Sonar0Jarvis Pennington1Mishell Siles Borda2Zaynah Sadiq3Matthew Beasey4Sathiyendram Poobalasingham5Internal Medicine, Norton Community Hospital, Norton, USALincoln Memorial University DeBusk College of Osteopathic Medicine, Harrogate, USAInternal Medicine, Norton Community Hospital, Norton, USAInternal Medicine, Norton Community Hospital, Norton, USAEndocrinology, Johnston Memorial Hospital, Abingdon, USANephrology, Bristol Regional Medical Center, Bristol, USADiabetic kidney disease is traditionally regarded as a complication of chronic hyperglycaemia associated with diabetes. However, the relationship between glycaemic thresholds and the development of diabetic kidney disease is increasingly questioned. We present a case of a 69-year-old woman with progressive renal dysfunction and biopsy findings suggestive of diabetic kidney disease, despite repeatedly normal glycosylated haemoglobin (haemoglobin A1c) and without a clinical diagnosis of diabetes or pre-diabetes. This case highlights the limitations of current haemoglobin A1c thresholds and raises the question of whether diabetic kidney disease can truly develop in the absence of diabetes. Stricter glycaemic criteria may help identify at-risk patients earlier and prevent renal complications.https://www.ejcrim.com/index.php/EJCRIM/article/view/5378ckd managementdiabetic kidney diseasediabetic nephropathydiabetes, endocrinology
spellingShingle Nirmay Sonar
Jarvis Pennington
Mishell Siles Borda
Zaynah Sadiq
Matthew Beasey
Sathiyendram Poobalasingham
Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
European Journal of Case Reports in Internal Medicine
ckd management
diabetic kidney disease
diabetic nephropathy
diabetes, endocrinology
title Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
title_full Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
title_fullStr Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
title_full_unstemmed Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
title_short Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes
title_sort rethinking glycemic thresholds diabetic kidney disease in the absence of overt diabetes
topic ckd management
diabetic kidney disease
diabetic nephropathy
diabetes, endocrinology
url https://www.ejcrim.com/index.php/EJCRIM/article/view/5378
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