Higher diversity of anti-diabetic therapy is associated with lower risk of major adverse kidney events in diabetes

Figure 1 Study flowchart. Study flowcharts for the UK Biobank cohort (left) and the Chongqing diabetes registry (right). HbA1c: Glycated hemoglobin A1c; PSM: Propensity score matching; MAKE: Major adverse kidney event; ESRD: Endstage renal disease.

Figure 2 Risk of major adverse kidney events, changes of hemoglobin A1c, and hypoglycemic events among patients who received monotherapy and combination anti-diabetic therapy. ^aP < 0.05. A: Kaplan-Meier curves of major adverse kidney events (MAKE) in UK biobank using a propensity score-matched method. Monotherapy: With a single anti-diabetic medication. Combination therapy: With ≥ 2 anti-diabetic medications. The MAKE is a composite of end-stage renal disease (defined as estimated glomerular filtration rate ≤ 15 mL/minute/1.73 m², initiation of dialysis, or undergoing kidney transplantation) or death attributed to kidney disease; B: Kaplan-Meier curves of MAKE in Chongqing Diabetes Registry using an emulation design of randomized target trial; C: Follow-up hemoglobin A1c levels between monotherapy and combination therapy groups in Chongqing Diabetes Registry; D: Self-reported hypoglycemic events between monotherapy and combination therapy groups in Chongqing Diabetes Registry. Hypoglycemic events include self-monitored fasting blood glucose levels < 3.9 mmol/L, or the presence of hypoglycemic symptoms (e.g., palpitations, sweating) without blood glucose measurement, which resolve after food intake.