{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:24:41Z","timestamp":1787117081208,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early kidney involvement may already be present at the diagnosis of type 2 diabetes mellitus (T2DM), whereas glycated hemoglobin A1c (HbA1c) and fasting plasma glucose do not fully characterize postprandial exposure. We evaluated the association of continuous glucose monitoring (CGM)-derived postprandial hyperglycemic area (PPHA) with 6-month change in urinary albumin-to-creatinine ratio (UACR) in adults with newly diagnosed T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study consecutively screened 381 adults with newly diagnosed diabetes who underwent professional CGM from January 1, 2020, to December 31, 2024. After predefined exclusions, 297 participants with valid 14-day CGM and baseline and 6-month UACR measurements were analyzed. PPHA was the daily mean threshold-excess area above 10.0 mmol\/L during 0\u20134 h after each main meal, calculated from valid monitoring days beginning on the first complete day after all components of the initial treatment regimen had been started. The primary outcome was \u0394lnUACR [ln(6-month UACR\u00a0+\u00a01)-ln(baseline UACR\u00a0+\u00a01)]; exploratory UACR worsening was secondary. Multivariable regression, restricted cubic spline analyses, treatment-interaction analyses, and sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      UACR worsening occurred in 88 participants (29.6%). \u0394lnUACR and the frequency of UACR worsening showed an increasing descriptive pattern across PPHA quartiles, with significant overall between-group differences (both\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). After adjustment for age, sex, body mass index, systolic blood pressure, HbA1c, fasting plasma glucose, estimated glomerular filtration rate, and baseline lnUACR, each 5 mmol\u00b7h\u00b7L\n                      <jats:sup>-<\/jats:sup>\n                      \u00b9\u00b7d\n                      <jats:sup>-<\/jats:sup>\n                      \u00b9 increase in PPHA was associated with a 0.08 higher \u0394lnUACR (95% confidence interval [CI], 0.05-0.12;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) and higher odds of UACR worsening (odds ratio [OR], 1.73; 95% CI, 1.27-2.36;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). The association was approximately linear (\n                      <jats:italic>P<\/jats:italic>\n                      for nonlinearity=0.932), remained directionally consistent after simultaneous adjustment for recorded chronic comorbidities, and showed no statistically significant interaction with initial metformin, insulin, sodium-glucose cotransporter 2 inhibitor, or glucagon-like peptide-1 receptor agonist therapy (all interaction\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher CGM-derived PPHA was associated with greater 6-month change in UACR after adjustment for fasting plasma glucose and HbA1c. PPHA may complement conventional glycemic measures in early kidney-risk assessment; external validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1890463","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:35:01Z","timestamp":1787114101000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of 14-day continuous glucose monitoring-derived postprandial hyperglycemic area with 6-month change in urinary albumin-to-creatinine ratio in patients with newly diagnosed type 2 diabetes mellitus"],"prefix":"10.3389","volume":"17","author":[{"given":"Tianchi","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"402","year":"2023","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.79235","article-title":"Prevalence of and factors associated with incidental chronic kidney disease in patients newly diagnosed with type 2 diabetes mellitus","volume":"17","author":"Alidrisi","year":"2025","journal-title":"Cureus"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2024-004854","article-title":"Change in urine albumin-to-creatinine ratio and clinical outcomes in patients with chronic kidney disease and type 2 diabetes","volume":"13","author":"Tangri","year":"2025","journal-title":"BMJ Open Diabetes Res Care"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.7326\/M23-2814","article-title":"Association of albuminuria with chronic kidney disease progression in persons with chronic kidney disease and normoalbuminuria: a cohort study","volume":"177","author":"Verma","year":"2024","journal-title":"Ann Intern Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"19785","DOI":"10.1038\/s41598-025-03382-0","article-title":"Variability and misclassification of albuminuria in patients with type 2 diabetes mellitus","volume":"15","author":"Buchwinkler","year":"2025","journal-title":"Sci Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1177\/11795514251370507","article-title":"Postprandial glucose: a variable in continuum","volume":"18","author":"Joshi","year":"2025","journal-title":"Clin Med Insights Endocrinol Diabetes"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac034","article-title":"Complications of diabetes and metrics of glycemic management derived from continuous glucose monitoring","volume":"107","author":"Yapanis","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v15.i4.591","article-title":"Application and management of continuous glucose monitoring in diabetic kidney disease","volume":"15","author":"Zhang","year":"2024","journal-title":"World J Diabetes"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241292041","article-title":"Consensus report on the use of continuous glucose monitoring in chronic kidney disease and diabetes","volume":"19","author":"Rhee","year":"2025","journal-title":"J Diabetes Sci Technol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/antiox13040455","article-title":"Oxidative stress: a culprit in the progression of diabetic kidney disease","volume":"13","author":"Wang","year":"2024","journal-title":"Antioxidants (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S002","article-title":"2. 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