The Impact of HbA1c Level on the Risk of End Stage Renal Disease in T2DM Patients with or without Hypertension: What is the Therapeutic Target?

Abstract

Objectives: This protocol is planned to determine the relationship between good control of hyperglycemia and the prevention of renal failure and/or kidney damage. While the relationship between poor control of high blood pressure in Type II Diabetes Mellitus (T2DM) and progression to kidney failure is clear, the ideal blood glucose marker measurement, glycosylated haemoglobin (HbA1c) target level to protect the kidneys is, as yet, unknown and there is an obvious need to identify this ideal HbA1c target. The design of this protocol will also investigate whether coexistence of high blood pressure would exacerbate kidney damage in T2DM. Methods: This protocol will examine different treatment intensity options to control hyperglycaemia and hypertension (if it is present) until a specific HbA1c target is reached in each group to identify the relation between level of glycaemic control and progression into chronic kidney disease. Participants will be from the Middle East & North Africa region (MENA), especially Egypt, Saudi Arabia, Kuwait and UAE. Those patients should have been confirmed with diagnosis for at least 10 years, with an HbA1c level of ≥ 8% with no history of cardiovascular events or diabetic foot disease. Patients with or without a confirmed coexistence of high blood pressure will be eligible to participate in this study. Conclusion: This study is designed to determine a clear-cut target HbA1c and recommendations for healthcare providers, and insurers to provide the best level of care for subjects living with T2DM. Despite the numerous publications that studied this important topic, none of them were aiming in the primary end point to determine the HbA1c target with the best kidney functions or less likely progressing to renal failure.