Estimated glucose disposal rate and microvascular complications of diabetes mellitus type I: A systematic review and meta-analysis

Objectives: This study aims to assess the association between the estimated glucose disposal rate (eGDR) and the risk of diabetic microvascular complications in patients with T1DM. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted up to August 2024, including studies that examined the relationship between eGDR and diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic neuropathy (DN) in patients with T1DM. A meta-analysis was performed to compare the eGDR values in patients with and without microvascular complications and assess the risk of these complications. Results: 22 studies were included. Lower eGDR values were significantly associated with a higher risk of microvascular complications. Specifically, a one-unit increase in eGDR was associated with a 18% reduction in the risk of DKD (ES: 0.82, 95% CI: 0.74–0.92), a 21% reduction in the risk of DR (OR: 0.79, 95% CI: 0.73–0.85). Patients with DKD, DR, and DN had eGDR values significantly lower by 1.29, 0.75, and 0.64 units, respectively, compared to those without complications. Conclusion: This meta-analysis highlights the potential role of eGDR as a non-invasive marker for the early detection of microvascular complications, highlighting the importance of regular eGDR monitoring to facilitate timely interventions.