Does acute kidney injury (AKI) alter glycemic patterns in hospitalized patients with type 2 diabetes mellitus (T2DM)? A prospective observational analysis published in Diabetic Medicine evaluated the relationship between kidney function and continuous glucose monitoring (CGM)-derived glycemic metrics in non-critically ill patients receiving basal-bolus insulin therapy.

The study included 166 hospitalized patients with T2DM monitored using CGM. Kidney function was assessed daily using plasma creatinine levels, and AKI was classified according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable models evaluated associations between kidney function and glycemic outcomes, including time in range (TIR), time above range (TAR), and time below range (TBR).

AKI was associated with a 7.3 percentage point reduction in TIR (95% CI 0.3-14.2). This reduction corresponded with increased TAR, while TBR did not show a significant change. For every 100 μmol/L increase in plasma creatinine, TIR decreased by 7.6%-points (95% CI 2.6-12.5). AKI was also associated with higher in-hospital mortality, increased intensive care unit admission, and a twofold higher risk of 30-day readmission.

Standard inpatient diabetes management often emphasizes hypoglycemia prevention. These findings indicate that AKI in T2DM is associated with higher hyperglycemia burden and adverse clinical outcomes, highlighting the need for close glycemic monitoring in this setting.