A large prospective cohort study published in BMJ Open Diabetes Research & Care has shown that both diagnosed and screen-detected DM substantially increase the risk of CKD and its subtypes among Chinese adults. The analysis included 472,545 participants from the China Kadoorie Biobank, with a mean follow-up of 11.8 years, assessing diabetes status and random plasma glucose (RPG) levels.

Participants with both screened and previously diagnosed diabetes had a more than fourfold higher risk of CKD (hazard ratio [HR] 4.52; 95% confidence interval [CI] 4.23–4.83) and a thirtyfold higher risk of DKD. Even those with pre-diabetes demonstrated elevated DKD risk, which increased progressively with higher RPG levels. Individuals with uncontrolled diabetes had significantly greater risks of CKD, DKD, and glomerulonephritis compared with participants maintaining controlled glucose levels.

The findings underscore that early diagnosis, consistent glycemic monitoring, and sustained glucose control are critical to mitigating the long-term burden of diabetes-related kidney disease, particularly in populations undergoing rapid metabolic transitions.