Association Between Continuous Glucose Monitoring-Derived Glycemia Risk Index and Albuminuria in Type 2 Diabetes

Background: The glycemia risk index (GRI) is a new composite metric derived from continuous glucosemonitoring (CGM) data to assess the quality of glycemia. This study investigates the association between theGRI and albuminuria.Methods:Professional CGM and urinary albumin-to-creatinine ratio (UACR) data from 866 individuals with type 2 diabetes were retrospectively reviewed. Albuminuria and macro albuminuria were defined as one or more UACR measurements double dagger 30 and double dagger 300 mg/g, respectively.Results: The overall prevalence of albuminuria and macroalbuminuria was 36.6% and 13.9%, respectively.Participants with a higher UACR had a significantly higher hyperglycemia component and GRI score than thosewith a lower UACR (allP<0.001), although the hypoglycemia component did not differ among the groups.Multiple logistic regression analyses that adjusted for various factors affecting albuminuria revealed that theodds ratio (OR) of albuminuria was 1.13 (95% confidence interval [CI]: 1.02-1.27,P=0.039) per increase inthe GRI zone. The results were similar for the risk of macroalbuminuria (OR: 1.42 [95% CI: 1.20-1.69],P<0.001), and that association remained after adjusting for glycated hemoglobin (OR: 1.31 [95% CI: 1.10-1.58],P=0.004).Conclusions: GRI is strongly associated with albuminuria, especially macroalbuminuria, in type 2 diabetes