Glycaemic variability and kidney-related outcomes in diabetes mellitus: a scoping review

Diabetic kidney disease (DKD) is a major complication of diabetes mellitus (DM) (Thomas et al., 2025). While long-term glycaemic control is commonly assessed using glycated haemoglobin (HbA1c), there is increasing interest in whether glycaemic variability may provide additional insight into risk of DKD development or progression (Subramanian and Hirsch, 2018). However, glycaemic variability is measured and defined in multiple ways, including continuous glucose monitoring-derived metrics, self-monitoring blood glucose-derived metrics, and visit-to-visit variability in HbA1c or blood glucose measures (Subramanian and Hirsch, 2018, Yapanis et al., 2022). Kidney outcomes are also heterogeneous, ranging from albuminuria, estimated glomerular filtration rate (eGFR), DKD progression, end-stage kidney disease, and various renal biomarkers (e.g., NGAL, Kim-1).