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Evaluation of 1,5-anhydroglucitol as a marker for glycemic variability in patients with type 2 diabetes mellitus

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Abstract

1,5-anhydroglucitol (1,5-AG) has been suggested as a marker for short-term glycemic control and postprandial hyperglycemia. However, the role of 1,5-AG in glycemic variability has not been established. The aim of this study was to demonstrate the usefulness of 1,5-AG as a marker for glycemic variability in patients with type 2 diabetes. Sixty patients with type 2 diabetes were enrolled, and a continuous glucose monitoring system (CGMS) was applied for 72 h. Continuous overlapping net glycemic action (CONGA), mean amplitude of glycemic excursion (MAGE), and mean of the daily differences (MODD) were calculated for the assessment of glycemic variability and compared with 1,5-AG. Urinary 8-iso prostaglandin F2α (8-isoPGF2α) was measured to assess oxidative stress. 1,5-AG was correlated with fasting blood glucose, HbA1c, postprandial area under the curve for glucose above 180 mg/dL (AUC-180), and mean post-meal maximum glucose (MPMG). However, 1,5-AG did not show significant correlation with CONGA-1, MAGE, and MODD (R = −0.053, P = 0.689; R = −0.148, P = 0.259; R = −0.123, P = 0.350). In patients with HbA1c ≤ 8.0% (n = 35), 1,5-AG was significantly correlated with HbA1c, mean glucose, postprandial AUC-180, and MPMG. However, in patients with HbA1c > 8.0% (n = 25), 1,5-AG did not show correlation with any glycemic markers. Oxidative stress measured as urine 8-isoPGF2α showed positive correlations with CONGA-1, MAGE, AUC-180, postprandial AUC-180, and MPMG only in men. However, 1,5-AG did not correlate with oxidative stress. Our data suggested a limited usefulness of 1,5-AG in estimating glycemic variability and oxidative stress. 1,5-AG was able to represent mean glucose and postprandial hyperglycemia only in well-controlled diabetic patients.

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Abbreviations

1,5-AG:

1,5-anhydroglucitol

CGMS:

Continuous glucose monitoring system

CONGA-1:

Continuous overlapping net glycemic action calculated with 1 h time intervals

MAGE:

Mean amplitude of glycemic excursion

MODD:

Mean of the daily differences

8-isoPGF2α :

8-iso prostaglandin F2α

AUC-180:

Area under the curve for glucose above 180 mg/dL

MPMG:

Mean post-meal maximum glucose

SMBG:

Self monitoring of blood glucose

SD:

Standard deviation

GFR:

Glomerular filtration rate

BMI:

Body mass index

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Acknowledgments

This study was supported by a grant from the Ministry for Health, Welfare & Family Affairs, Republic of Korea (the Korea Healthcare 21 R & D Project: 00-PJ3-PG6-GN07-001 and the Innovative Research Institute for Cell Therapy: A062260).

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea

    Min Joo Kim, Hye Seung Jung, Yul Hwang-Bo, Sun Wook Cho, Seong Yeon Kim & Kyong Soo Park

  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Hak Chul Jang

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  1. Min Joo Kim
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Correspondence to Kyong Soo Park.

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Kim, M.J., Jung, H.S., Hwang-Bo, Y. et al. Evaluation of 1,5-anhydroglucitol as a marker for glycemic variability in patients with type 2 diabetes mellitus. Acta Diabetol 50, 505–510 (2013). https://doi.org/10.1007/s00592-011-0302-0

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