Incident Type 2 Diabetes in Individuals With CKD: The REGARDS Study.
7 affiliations
- 1Department of Biostatistics, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
- 2Department of Medicine, Medical University of South Carolina, Charleston, SC.
- 3Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
- 4Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
- 5Division of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
- 6Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC.
- 7Department of Epidemiology, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Abstract
Rationale & objective
Chronic kidney disease (CKD) and diabetes are comorbid metabolic diseases that share common factors such as insulin resistance. Few studies have examined the association between CKD and incident diabetes, with limited consensus and associated risk factors. We conducted an analysis of participants in the Reasons for Geographic and Racial Differences in stroke study to investigate incident diabetes among participants with CKD compared with non-CKD participants.Study design
A prospective cohort study.Setting & participants
Total of 7,511 participants who completed 10 years of follow-up were included in the analysis, of whom 994 had CKD (an estimated glomerular filtration rate <60 mL/min/1.73m² or albumin-to-creatinine ratio >30mg/g) at baseline.Exposure
CKD.Outcome
Incident diabetes.Analytical approach
Logistic regression analysis was performed to estimate the odds of incident diabetes among CKD participants, with odds ratio (OR) and 95% CI. Risk factors for incident diabetes among CKD participants were also examined.Results
After 10 years of follow-up, 11.0% (717) of non-CKD participants and 15.8% (157) of CKD participants developed diabetes. Incident diabetes was higher among CKD participants than in non-CKD participants using creatinine-based equations, which was not seen when using a creatinine-based and cystatin C-based equation for CKD. Several risk factors such as race, prediabetes, age, body mass index, hypertension, current smoking, and exercise ≥ 4 times/week increased the odds of incident diabetes, whereas current alcohol use had a lower risk of incident diabetes. Prediabetes had the highest risk of incident diabetes (OR = 4.94, 95% Cl: 4.22-5.78; P < 0.01).Limitations
Attrition bias, limited generalizability, and limited diagnostic classification.Conclusions
The association between CKD and incident diabetes depends on how CKD is defined. These findings highlight the need for future studies to explore how renal function is assessed when determining adverse outcomes related to CKD.
Related
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- Use of SGLT2 Inhibitors, GLP‐1 Receptor Agonists, and DPP‐4 Inhibitors in Incident Hyponatremia in Patients with Type 2 Diabetes: Multicenter Target Trial Emulations
- Ultraprocessed foods and incident type 2 diabetes: analysis of the Hispanic Community Health Study/Study of Latinos
- Diagnosing and Managing Type 2 Diabetes in South Asian Individuals: A Clinician’s Guide
- Visceral adipose tissue and incident cardiovascular disease among individuals without diabetes: an analysis of 15 prospective cohorts from 7 countries in Latin America
BibTeX
@article{li2026incident,
title = {{Incident Type 2 Diabetes in Individuals With CKD: The REGARDS Study.}},
author = {Xingsheng Li and Javier A Jurado Vélez and Nita Kanney and Archie Landrum and Lloyd J Edwards and Orlando M Gutierrez and D Leann Long and Bertha Hidalgo},
journal = {Kidney medicine},
year = {2026},
month = aug,
doi = {10.1016/j.xkme.2026.101498},
url = {https://europepmc.org/article/MED/42898242},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Incident Type 2 Diabetes in Individuals With CKD: The REGARDS Study.
AU - Xingsheng Li
AU - Javier A Jurado Vélez
AU - Nita Kanney
AU - Archie Landrum
AU - Lloyd J Edwards
AU - Orlando M Gutierrez
AU - D Leann Long
AU - Bertha Hidalgo
PY - 2026
DA - 2026/08/13
JO - Kidney medicine
DO - 10.1016/j.xkme.2026.101498
UR - https://europepmc.org/article/MED/42898242
AB - Rationale & objective Chronic kidney disease (CKD) and diabetes are comorbid metabolic diseases that share common factors such as insulin resistance. Few studies have examined the association between CKD and incident diabetes, with limited consensus and associated risk factors. We conducted an analysis of participants in the Reasons for Geographic and Racial Differences in stroke study to investigate incident diabetes among participants with CKD compared with non-CKD participants.Study design A prospective cohort study.Setting & participants Total of 7,511 participants who completed 10 years of follow-up were included in the analysis, of whom 994 had CKD (an estimated glomerular filtration rate <60 mL/min/1.73m² or albumin-to-creatinine ratio >30mg/g) at baseline.Exposure CKD.Outcome Incident diabetes.Analytical approach Logistic regression analysis was performed to estimate the odds of incident diabetes among CKD participants, with odds ratio (OR) and 95% CI. Risk factors for incident diabetes among CKD participants were also examined.Results After 10 years of follow-up, 11.0% (717) of non-CKD participants and 15.8% (157) of CKD participants developed diabetes. Incident diabetes was higher among CKD participants than in non-CKD participants using creatinine-based equations, which was not seen when using a creatinine-based and cystatin C-based equation for CKD. Several risk factors such as race, prediabetes, age, body mass index, hypertension, current smoking, and exercise ≥ 4 times/week increased the odds of incident diabetes, whereas current alcohol use had a lower risk of incident diabetes. Prediabetes had the highest risk of incident diabetes (OR = 4.94, 95% Cl: 4.22-5.78; P < 0.01).Limitations Attrition bias, limited generalizability, and limited diagnostic classification.Conclusions The association between CKD and incident diabetes depends on how CKD is defined. These findings highlight the need for future studies to explore how renal function is assessed when determining adverse outcomes related to CKD.
SN - 2590-0595
ER -