Lifestyle Factors Contribute to Risk of Diabetic Nephropathy
Investigators find that unhealthy eating and inadequate or excessive sleeping duration could contribute to developing diabetic nephropathy.
Unhealthy eating and inadequate or excessive sleeping duration could contribute to developing diabetic nephropathy, according to results of a study published in the Journal of Diabetes Investigation. However, investigators did not find a significant association between diabetic nephropathy and smoking or drinking.1
Investigators find that unhealthy eating and inadequate or excessive sleeping duration could contribute to developing diabetic nephropathy. | Image Credit: manassanant - stock.adobe.com
Diabetic nephropathy is the leading cause of end-stage renal failure in the United States, according to StatPearls. Early treatment can help to delay or prevent the progression of end-stage kidney failure. Although the condition can develop in patients with either type 1 diabetes (T1D) or type 2 diabetes (T2D), over 90% of cases are for patients with T2D. Current treatment focuses on reducing the risk of cardiovascular disease, glycemic control, blood pressure control, and inhibition of the renin-angiotensin system.2
Diabetes can cause the kidneys to be damaged, which usually progresses slowly over many years. High blood glucose damages blood vessels in the kidney, impacting how the kidneys can filter blood, leading to waste buildup in the body. Healthy lifestyle habits can help improve health, according to the National Institute of Diabetes and Digestive and Kidney Diseases.3
“Many studies have shown that lifestyle, particularly eating habits, physical activity, sleep, smoking, and drinking, is associated with diabetes and its complications. However, previous research on eating habits and DN [diabetic nephropathy] often focused on specific foods, lacking a comprehensive assessment, while studies on physical activity and DN used inconsistent definitions of form and intensity,” the study authors stated.1
The investigators of the study aimed to use the Healthy Eating Index (HEI), Metabolic Equivalent (MET), sleeping duration, smoking, and drinking status to determine the impact of lifestyle factors on renal dysfunction for patients with diabetes. There were 2389 patients aged 18 to 64 years from the National Health and Nutrition Examination Survey 2007 to 2018. Patients were non-pregnant and received a diagnosis of diabetes, and 50% were male.
Patients who had diabetic nephropathy had a longer duration of diabetes, and higher prevalence of diabetic retinopathy and cardiovascular disease. They also had higher body mass indexes and worse hemoglobin A1c.1
Patients in the diabetic nephropathy group had lower HEI levels compared with those that did not have the condition, and they had inadequate sleep duration (less than 5 hours). There were no statistically significant differences in MET, smoking status, or drinking status. Further, the investigators reported that HEI scores between 40% and 60% or less than 40% increased the likelihood of developing diabetic nephropathy, as did sleep duration of less than 5 hours.1
In a subgroup analysis, there was a stronger association between HEI and diabetic nephropathy in patients less than 50 years old with normal blood pressure, hemoglobin A1c of less than 7%, and without dyslipidemia. Sleep duration had a stronger association for patients 50 years or older, a blood pressure of over 140/90 mmHg, hemoglobin A1c, and dyslipidemia.1
“Non-linear analyses further reveal a positive correlation between unhealthy eating habits and the risk of DN. Proper physical activity and sleeping duration can reduce the risk of DN,” the study authors concluded. “Our findings suggest that, in addition to managing metabolic risk factors, it is essential to promote healthy lifestyles among diabetic patients to effectively prevent the onset and progression of diabetic nephropathy.”
READ MORE: Diabetes Resource Center
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