ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)
A 3-year follow-up of a diabetes-nephrology outpatient service for managing patients with type 2 diabetes and chronic kidney disease
Sabrina Berti 1,2 , Danilo Ribichini 1 , Irene Capelli 2,3 , Ginevra Moschione 1,2 , Valentina Vicennati 1,2 , Giuseppe Cianciolo 2,3 , Valeria Aiello 2,3 , Sarah Lerario 2,3 , Simona Barbuto 2,3 , Daniele Vetrano 2,3 , Giacomo Credi 1,2 , Gaetano La Manna 2,3 & Uberto Pagotto 1,2
1IRCCS Policlinico S. Orsola, Endocrinology and Diabetes Prevention and Care Unit, Bologna, Italy; 2University of Bologna, Department of Medical and Surgical Sciences (DIMEC), Bologna, Italy; 3IRCCS Policlinico S. Orsola, Nephrology, Dialysis and Transplantation Department, Bologna, Italy
JOINT3480
Background and Aims: Diabetic Kidney Disease (DKD) is one of the most common complications of diabetes mellitus (DM) and the leading cause of dialysis worldwide. Previous multidisciplinary approaches have been attempted with varying success. This study aims to assess the results of a three-year diabetes-nephrology outpatient program established at an Italian Research Hospital.
Materials and Methods: A single-centre, retrospective, observational study involving 306 patients with type 2 DM and CKD, who received at least two evaluations in the multidisciplinary service, consisting in simultaneous joint medical visits conducted by a diabetologist and a nephrologist. Anthropometric and biochemical parameters, as well as therapies, were compared between first evaluation (V0) and latest follow-up visit (V1). Estimated glomerular filtration rate (eGFR) slope was calculated as (eGFR V1- eGFR V0)/(time of follow-up).
Results: Of the 306 patients evaluated, 60,5 % had stage G3a-G3b CKD and 58,7% had stage A3 albuminuria according to KDIGO classification. Mean time of follow-up was 27 ± 12 months. Significant improvements between V0 and V1 were seen in BMI (mean BMI at V0 30,5 ± 7,4 vs 29,4 ± 5,4 kg/m2 at V1, P<0,001), waist circumference, systolic and diastolic blood pressure, total and LDL-cholesterol (LDL-c V0 93,8 ± 41,2 vs LDL-c V1 70,2 ±34,2 mg/dl, P<0,001), triglycerides (170,5 ± 124,1 vs 143,1 ± 65,9 mg/dl, P<0,001), uric acid and HbA1c (mean HbA1c 55,8 ± 12,8 at V0 vs 52,2 ± 11,5 mmol/mol at V1, P<0,001). In the multivariate regression analysis, greater reduction in HbA1c was associated with higher baseline HbA1c and treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA). The eGFR showed a significant decline between V0 and V1 (52,3 ± 22,6 at V0 vs 48,6 ± 22,9 ml/min at V1, P<0,001), with a mean eGFR slope of -2,1±7,0 mL/min/1,73m2/year. Moreover, a significant reduction in urine albumin-creatinine ratio (uACR) was observed from V0 to V1 (median uACR at V0 138,5 [23-554] mg/g vs. 83,5 [20 - 501] mg/g at V1, P = 0,002). In a multivariate regression analysis, a slower eGFR decline was linked to treatment with sodium glucose co-transporter 2 inhibitors (SGLT2i), while a higher baseline eGFR, greater baseline 24-hour proteinuria and older age were associated with faster eGFR decline.
Conclusions: This study suggests an effective and simply viable model of care for the integrated management of co-morbid type 2 DM and CKD and confirms the central role of SGLT2i and GLP-1 RA in this context.
Volume 110
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Endocrine Abstracts
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