DOI: 10.12890/2025_005378

Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes

Authors

  • Nirmay Sonar Internal Medicine, Norton Community Hospital, Norton, USA
  • Jarvis Pennington Lincoln Memorial University DeBusk College of Osteopathic Medicine, Harrogate, USA
  • Mishell Siles Borda Internal Medicine, Norton Community Hospital, Norton, USA
  • Zaynah Sadiq Internal Medicine, Norton Community Hospital, Norton, USA
  • Matthew Beasey Endocrinology, Johnston Memorial Hospital, Abingdon, USA
  • Sathiyendram Poobalasingham Nephrology, Bristol Regional Medical Center, Bristol, USA

docnirmay@gmail.com

Keywords

CKD management, diabetic kidney disease, diabetic nephropathy, diabetes, endocrinology

Abstract

Diabetic kidney disease is traditionally regarded as a complication of chronic hyperglycaemia associated with diabetes. However, the relationship between glycaemic thresholds and the development of diabetic kidney disease is increasingly questioned. We present a case of a 69-year-old woman with progressive renal dysfunction and biopsy findings suggestive of diabetic kidney disease, despite repeatedly normal glycosylated haemoglobin (haemoglobin A1c) and without a clinical diagnosis of diabetes or pre-diabetes. This case highlights the limitations of current haemoglobin A1c thresholds and raises the question of whether diabetic kidney disease can truly develop in the absence of diabetes. Stricter glycaemic criteria may help identify at-risk patients earlier and prevent renal complications.

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Published

2025-07-03

Issue

Vol. 12 No. 8 (2025)

Categories

How to Cite

1.
Sonar N, Pennington J, Siles Borda M, Sadiq Z, Beasey M, Poobalasingham S. Rethinking glycemic thresholds: diabetic kidney disease in the absence of overt diabetes. EJCRIM [Internet]. 2025 Jul. 3 [cited 2026 Nov. 3];12(8). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5378