Unhealthy eating habits and improper sleep duration—either too little or too much—may significantly increase the risk of diabetic nephropathy, according to a new study published in the Journal of Diabetes Investigation. However, the researchers found no meaningful link between diabetic kidney disease and lifestyle factors such as smoking or alcohol consumption.
Diabetic nephropathy, a serious complication of diabetes, is the leading cause of end-stage renal failure in the United States. While the condition can affect individuals with either type 1 or type 2 diabetes, over 90% of cases are associated with type 2 diabetes (T2D). Early intervention is critical to slowing its progression, with current treatments focusing on cardiovascular risk reduction, glycemic control, blood pressure management, and inhibiting the renin-angiotensin system.
The kidneys are particularly vulnerable to long-term damage from high blood sugar, which harms the blood vessels that filter waste from the body. Over time, this damage can lead to chronic kidney disease and eventual kidney failure. According to the National Institute of Diabetes and Digestive and Kidney Diseases, adopting a healthy lifestyle is a key strategy in mitigating these risks.
“Many studies have shown the link between lifestyle factors—such as eating habits, physical activity, sleep, smoking, and drinking—and diabetes complications,” the study authors noted. “However, previous research on diabetic nephropathy (DN) has often been limited to specific foods or used inconsistent definitions of exercise intensity.”
Comprehensive Analysis of Lifestyle Factors
To address these gaps, investigators conducted a large-scale analysis using data from 2,389 adults aged 18 to 64 with diagnosed diabetes, drawn from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. Half of the participants were male, and none were pregnant.
Researchers assessed participants’ lifestyle habits using several metrics, including the Healthy Eating Index (HEI), Metabolic Equivalent of Task (MET) for physical activity, sleep duration, and smoking and drinking status.
Key findings revealed that patients with diabetic nephropathy typically had:
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Longer duration of diabetes
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Higher rates of diabetic retinopathy and cardiovascular disease
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Increased body mass index (BMI)
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Poorer glycemic control, as reflected by elevated hemoglobin A1c levels
Critically, those with diabetic nephropathy exhibited significantly lower HEI scores, indicating poorer overall diet quality. Additionally, sleep deprivation—defined as fewer than 5 hours of sleep per night—was associated with a heightened risk of developing the condition. In contrast, no statistically significant relationship was found between diabetic nephropathy and MET levels, smoking habits, or alcohol consumption.
The analysis further revealed that patients with HEI scores below 60% faced a substantially increased likelihood of developing diabetic nephropathy. Short sleep duration emerged as another prominent risk factor.
Age and Health Status Influence Lifestyle Risks
Subgroup analyses uncovered nuanced relationships between lifestyle factors and kidney disease risk. For individuals younger than 50, poor diet quality was more strongly associated with diabetic nephropathy, particularly among those with normal blood pressure, hemoglobin A1c levels below 7%, and no history of dyslipidemia. Conversely, in patients aged 50 and older, inadequate sleep duration had a greater impact, especially for those with high blood pressure, elevated hemoglobin A1c, and lipid abnormalities.
“Our findings underscore the importance of promoting healthy lifestyle behaviors—not just managing metabolic risk factors—to prevent the onset and progression of diabetic nephropathy,” the researchers concluded. “Unhealthy eating habits show a clear positive correlation with increased DN risk, while maintaining proper physical activity and adequate sleep duration can offer protective benefits.”
While further research is warranted, this study reinforces the critical role of comprehensive lifestyle interventions in managing diabetes and its severe complications.
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