Objective:

To assess the association between visit-to-visit HbA1c variability and subsequent renal function decline in older Chinese adults with type 2 diabetes.

Approach:

Key Findings:

• The cohort included 630 participants with a mean age of 72.9 years.
• 247 primary renal events occurred during a median follow-up of 4.6 years.
• Each 5% absolute increase in HbA1c-CV was associated with a higher risk of renal decline (HR 1.19, 95% CI 1.08–1.31; p < 0.001).
• Participants in the highest tertile of HbA1c-CV had a higher risk of renal decline compared to the lowest tertile (HR 1.58, 95% CI 1.18–2.11; p = 0.002).

Interpretation:

Greater visit-to-visit HbA1c variability was independently associated with subsequent renal function decline.

Limitations:

• Incremental predictive value of HbA1c variability beyond established kidney markers was not tested.
• The study was conducted at a single center, which may limit generalizability.

Conclusion:

Higher visit-to-visit HbA1c variability is associated with renal function decline in older adults with type 2 diabetes.

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