Publication Name	World Journal of Diabetes
Manuscript ID	120343
Country	China

Category	Endocrinology & Metabolism
Manuscript Type	Retrospective Cohort Study
Article Title	Dynamic glycemic exposure and trajectory profiling for incident diabetic kidney disease: A longitudinal cohort study
Manuscript Source	Unsolicited Manuscript
All Author List	Hui-Yu Zou, Hao Jiang, Xiao-Di Guo, Zhe-Yao Wen, Yi Shi, An-Dong Zhou, Man-Man Wang, Fen Xu and Meng-Yin Cai
Funding Agency and Grant Number	Funding Agency Grant Number National Natural Science Foundation of China No. 82270942 Natural Science Foundation of Guangdong Province No. 2026A1515012884 Noncommunicable Chronic Diseases-National Science and Technology Major Project No. 2024ZD0523200
Corresponding Author	Meng-Yin Cai, Chief Physician, PhD, Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, China. caimengyin@mail.sysu.edu.cn
Key Words	Diabetic kidney disease; Type 2 diabetes mellitus; Time-weighted average glycated hemoglobin; Glycated hemoglobin trajectories; Glycemic control
Core Tip	This study demonstrates that dynamic glycemic tracking using time-weighted average glycated hemoglobin (HbA1c) significantly outperforms static baseline measurements in predicting incident diabetic kidney disease (DKD) in type 2 diabetes. We identified a critical non-linear risk inflection at 7.0% HbA1c, beyond which renal risk escalates precipitously. Furthermore, longitudinal trajectory profiling revealed that rapid early correction of severe hyperglycemia is associated with an attenuated risk of long-term renal deterioration. These findings highlight the prognostic superiority of quantifying cumulative glucotoxicity and emphasize that early, intensive glycemic intervention may be crucial to overcome therapeutic inertia and potentially mitigate the risk of DKD.
Citation	Zou HY, Jiang H, Guo XD, Wen ZY, Shi Y, Zhou AD, Wang MM, Xu F, Cai MY. Dynamic glycemic exposure and trajectory profiling for incident diabetic kidney disease: A longitudinal cohort study. World J Diabetes 2026; In press

Received	2026-02-24 00:48
Peer-Review Started	2026-02-25 02:02
First Decision by Editorial Office Director	2026-03-03 09:22
Return for Revision	2026-03-03 09:22
Revised	2026-03-13 07:18
Publication Fee Transferred	2026-03-15 14:33
Second Decision by Editor	2026-04-10 02:48
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-17 05:45
Articles in Press	2026-04-17 05:45
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9358 (online)
Open Access	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com