1,5-anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes.

Abstract

OBJECTIVE:

Postprandial hyperglycemia is often inadequately assessed in diabetes management. Serum 1,5-anhydroglucitol (1,5-AG) drops as serum glucose rises above the renal threshold for glucose and has been proposed as a marker for postprandial hyperglycemia. The objective of this study is to demonstrate the relationship between 1,5-AG and postprandial hyperglycemia, as assessed by the continuous glucose monitoring system (CGMS) in suboptimally controlled patients with diabetes.

RESEARCH DESIGN AND METHODS:

Patients with type 1 or type 2 diabetes and an HbA(1c) (A1C) between 6.5 and 8% with stable glycemic control were recruited from two sites. A CGMS monitor was worn for two consecutive 72-h periods. Mean glucose, mean postmeal maximum glucose (MPMG), and area under the curve for glucose above 180 mg/dl (AUC-180), were compared with 1,5-AG, fructosamine (FA), and A1C at baseline, day 4, and day 7.

RESULTS:

1,5-AG varied considerably between patients (6.5 +/- 3.2 mug/ml [means +/- SD]) despite similar A1C (7.3 +/- 0.5%). Mean 1,5-AG (r = -0.45, P = 0.006) correlated with AUC-180 more robustly than A1C (r = 0.33, P = 0.057) or FA (r = 0.38, P = 0.88). MPMG correlated more strongly with 1,5-AG (r = -0.54, P = 0.004) than with A1C (r = 0.40, P = 0.03) or FA (r = 0.32, P = 0.07).

CONCLUSIONS:

1,5-AG reflects glycemic excursions, often in the postprandial state, more robustly than A1C or FA. 1,5-AG may be useful as a complementary marker to A1C to assess glycemic control in moderately controlled patients with diabetes.

• Authors: Kathleen M Dungan, John B Buse, Joseph Largay, Mary M Kelly, Eric A Button, Shuhei Kato, Steven Wittlin
• Journal: Diabetes care (Diabetes Care) Vol. 29 Issue 6 Pg. 1214-9 (Jun 2006) ISSN: 0149-5992 [Print] United States
• PMID: 16731998 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A
• Fructosamine
• 1,5-anhydroglucitol
• Deoxyglucose

Topics

• Deoxyglucose (blood)
• Diabetes Mellitus, Type 1 (blood)
• Diabetes Mellitus, Type 2 (blood)
• Fructosamine (blood)
• Glycated Hemoglobin (analysis)
• Humans
• Hyperglycemia (epidemiology)
• Monitoring, Ambulatory (methods)
• Monitoring, Physiologic (methods)
• Postprandial Period
• Reproducibility of Results