Diabetes mellitus in chronic kidney disease: Biomarkers beyond HbA1c to estimate glycemic control and diabetes-dependent morbidity and mortality

Sidar Copur, Emine M. Onal, Baris Afsar, Alberto Ortiz, Daniel H. van Raalte, David Z. Cherney, Peter Rossing, Mehmet Kanbay*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). Optimal glycemic control contributes to improved outcomes in patients with DM, particularly for microvascular damage, but blood glucose levels are too variable to provide an accurate assessment and instead markers averaging long-term glycemic load are used. The most established glycemic biomarker of long-term glycemic control is HbA1c. Nevertheless, HbA1c has pitfalls that limit its accuracy to estimate glycemic control, including the presence of altered red blood cell survival, hemoglobin glycation and suboptimal performance of HbA1c assays. Alternative methods to evaluate glycemic control in patients with DM include glycated albumin, fructosamine, 1–5 anhydroglucitol, continuous glucose measurement, self-monitoring of blood glucose and random blood glucose concentration measurements. Accordingly, our aim was to review the advantages and pitfalls of these methods in the context of CKD.
Original languageEnglish
Article number107707
JournalJournal of Diabetes and its Complications
Issue number11
Early online date2020
Publication statusPublished - Nov 2020

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