Work

Incident Type 2 Diabetes in Individuals With CKD: The REGARDS Study

Year: 2026

Type: article

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 (REGARDS) study to investigate incident diabetes among participants with CKD compared to non-CKD participants. Study Design Prospective cohort study Setting & Participants 7,511 participants who completed 10 years of follow-up were included in the analysis, of whom 994 had CKD (eGFR <60ml/min/1.73m 2 or ACR>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% Confidence Interval (Cl). 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- and cystatin C-based equation for CKD. Several risk factors such as race, prediabetes, age, body mass index (BMI), hypertension, current smoking, and exercise ≥ 4 times/week increased the odds of incident diabetes, while 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.

Source: Kidney Medicine

DOI: 10.1016/j.xkme.2026.101498