Evaluation of the Role of Estimated Glucose Disposal Rate in Assessment of Renal Functions in Patients with Type 2 Diabetes Mellitus

Background:Insulin resistance (IR) is a recognized contributing factor to diabetic nephropathy in diabetic patients. However, data regarding its significance in the development of nephropathy in this population remain limited. The estimated glucose disposal rate (eGDR), a novel biomarker for insulin sensitivity derived from three clinically accessible variables, was originally established in type 1 diabetes (T1D) and has recently been validated in type 2 diabetes (T2D) using the gold-standard euglycemic-hyperinsulinemic clamp technique. Objective: We hypothesized that a diminished eGDR is associated with an elevated risk of diabetic nephropathy (DN) in individuals with T2D. Patients and Methods:Forty patients with T2D were recruited from the Internal Medicine Department, Tanta University Hospitals, as well as 20 healthy individuals as control, between November 2022 and August 2023. eGDR (mg/kg/min) was calculated using the formula: 24.31 - (12.22 × waist to hip ratio)- (3.29 × hypertension, 1=yes 0=no) - (0.57 × HbA1c%). A lower eGDR indicates higher IR. Results:The study included patients aged between 27 and 70 years. eGDR showed a significant increase across all study groups (p-value < 0.001). Individuals with diabetes and chronic kidney disease demonstrated a lower eGDR compared to other groups. Conclusions:A higher eGDR is strongly associated with a lower risk of diabetic nephropathy in individuals with T2D, suggesting that IR plays a significant role in the pathogenesis of DN.