A study published in Diabetes Care has found that maintaining HbA1c levels between 6.7% and 7.1% may significantly lower the risk of serious complications in people living with both diabetes and severe chronic kidney disease (CKD).

The research included 27,113 adults with diabetes and severe CKD (eGFR <30 mL/min/1.73 m²) from 2010 to 2022. For comparison, two control groups were examined. One control group included 80,131 individuals with mild-to-moderate CKD, and the other control group had 80,797 individuals with no-to-mild CKD.

Researchers analyzed the 1-year risk of major adverse cardiovascular events (MACE), microvascular complications, and hospitalizations due to hypoglycemia across different HbA1c levels.

The results reported a U-shaped association between HbA1c and adverse outcomes. In people with severe CKD, MACE risk increased significantly when HbA1c is ≥7.2% or <5.8%, compared with the reference range of 6.3–6.6%.

Microvascular complication risk also increased at HbA1c levels of ≥7.2%, while hypoglycemia-related hospitalizations were notably more frequent at HbA1c levels ≥6.7%.