1,5-anhydroglucitol And Postprandial Hyperglycemia as Assessed by Self-monitoring of Blood Glucose in Japanese Patients with Moderately Controlled Diabetes
Abstract Number: 0423-P
Authors: TOSHIE AKUTSU, YUTAKA MORI, YOHTA ITOH, NAOKO TAJIMA, Tokyo, Japan, Kawachi-gun, Japan
Results: Objective: Postprandial hyperglycemia is often inadequately assessed in diabetes management. 1,5-anhydroglucitol (1,5-AG) as an index for urinary glucose is known to sensitively reflect glycemic excursions, as it varies even in relatively good glycemic states, and is thus thought to represent an appropriate index for evaluation of postprandial hyperglycemia. In this study, we investigated the relationship between postprandial hyperglycemia as assessed by self-monitoring of blood glucose and 1,5-AG in patients with moderately controlled diabetes.
Methods: A total of 36 patients with type 2 diabetes aged 41 to 75 years of age with stable glycemic control whose HbA1c ranged between 5.5% and 8% were enrolled in the study. During the 1 month before their outpatient visits, glucose levels were measured in the subjects using a blood glucose meter before and after meals for a total of 6 times on 4 days within 1 week of each other. Based on these measurements, mean glucose, mean postprandial maximum glucose (MPMG), Σ for postprandial glucose, Σ for postprandial glucose above 180 mg/dL were analyzed to compare 1,5-AG, glycated albumin (GA), and HbA1c among the patients.
Results: 1,5-AG varied considerably between the patients (10.9 ± 5.9 µg/ml [mean ± SD]) despite similar HbA1c (6.5 ± 0.7 %). 1,5-AG correlated more robustly with Σ for postprandial glucose above 180 mg/dL than with HbA1c or GA. MPMG correlated more strongly with 1,5-AG than with HbA1c or GA. When divided into the upper (n = 18) and lower (n = 18) 50th percentile in terms of Σ for postprandial glucose above 180 mg/dL, patients in the upper 50th percentile had significantly lower 1,5-AG values, and significantly higher MPMG values, compared to those in the lower 50th percentile, while there were no significant differences noted between the two groups in HbA1c and GA.
Conclusions: 1,5-AG has been shown to reflect glycemic excursions, often in the postprandial state, more robustly than HbA1c or GA. 1,5-AG may prove useful as an adjunct marker to HbA1c in the assessment of glycemic control in patients with moderately controlled diabetes.