Ahead of World Diabetes Day, Emirati physician explains how insulin resistance and other metabolic risk factors can affect kidney health before blood sugar levels become elevated
People with normal blood sugar levels may still be at risk of developing kidney disease as other metabolic problems, including insulin resistance, excess visceral fat and high cholesterol, can also affect kidney health, according to Dr. Hassa Al-Zaabi, Specialist Nephrologist at Dubai-based OMICS Precision Health, speaking ahead of World Diabetes Day on November 14.
Chronic kidney disease is a growing global health concern. The World Health Organization (WHO) estimates that approximately 674 million people worldwide are living with the condition, equivalent to around 9% of the global population. In a resolution adopted in 2025, the WHO described kidney disease as one of the fastest-growing causes of death globally and noted that it is projected to become the fifth leading cause of death by 2050.
While diabetes is a major risk factor for chronic kidney disease (CKD), other metabolic conditions can also affect kidney health, even when blood sugar levels are normal. Insulin resistance, for example, can develop before blood glucose levels become elevated, meaning that underlying metabolic problems may go undetected by routine glucose tests.
“Kidney health is influenced by a range of factors, and underlying metabolic problems can go undetected for years before signs of kidney damage become apparent,” Dr. Al-Zaabi said. “It’s not uncommon for a person to have normal glucose readings while already experiencing insulin resistance. We also need to consider excess visceral fat and abnormal cholesterol levels, because these can contribute to inflammation and damage to the blood vessels supplying the kidneys.”
The link between metabolic health and kidney function:
Excess visceral fat and abnormal blood lipid levels are associated with inflammation and impaired blood vessel function, affecting the circulation that supplies vital organs, including the kidneys. Over time, these changes can contribute to kidney damage, potentially before noticeable symptoms develop.
“One of the earliest signs of kidney injury is albuminuria, which means that a protein called albumin starts leaking into the urine,” Dr. Al-Zaabi explained. “This can appear years before kidney function tests in the blood show any abnormalities. Someone might have a normal kidney function result, but a urine test could reveal that damage has already started. This is why screening plays such an important role in prevention.”
Dr. Al-Zaabi recommends two essential types of screening: blood tests measuring kidney function and urine tests detecting albumin. Blood tests typically measure serum creatinine, which is used to calculate the estimated glomerular filtration rate (eGFR), an indicator of how effectively the kidneys filter waste. Cystatin C can also be measured alongside creatinine to provide a more precise assessment in certain patients.
The second important test is the urine albumin-to-creatinine ratio (uACR), which can detect early kidney damage before conventional blood tests become abnormal.
People with diabetes, high blood pressure, cardiovascular disease, obesity, insulin resistance or elevated cholesterol should be particularly mindful of their kidney health and discuss appropriate screening with their doctor. “For higher-risk patients, I may recommend checking kidney function every three to six months, rather than waiting for an annual assessment,” Dr. Al-Zaabi said. “The earlier we identify changes, the greater the opportunity to intervene.”
Lifestyle changes can help protect kidney health:
Alongside screening, Dr. Al-Zaabi emphasised the importance of lifestyle factors in maintaining kidney function and reducing metabolic risk. Managing blood pressure is particularly important, with people affected by hypertension encouraged to reduce salt intake, exercise regularly and follow a balanced diet. Dr. Al-Zaabi recommends a Mediterranean-style diet, which typically has plenty of vegetables, fruits and other plant-based foods, alongside appropriate amounts of protein. Regular physical activity, adequate sleep and stress management can also support metabolic health.
“Lifestyle changes are always where I start with patients. Medication can help control blood pressure and protect the kidneys, but it works alongside the changes people make to their daily habits,” Dr. Al-Zaabi said. “If someone continues to consume too much salt, remains physically inactive or does not get enough sleep, it makes it much harder to protect their kidneys.”
OMICS Precision Health is located at Villa 504B, Jumeirah Street, Jumeirah 3, Dubai. More information is available at http://www.omics-health.com.
About OMICS Precision Health:
OMICS Precision Health is a Dubai-based healthspan medicine clinic applying translational geroscience to support early intervention and long-term healthy aging across the GCC. The clinic integrates advanced clinical diagnostics, multi-omics analysis, imaging, and longitudinal monitoring within a medically governed framework.
