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Generally, the level of glycoalbumin (GA) is approximately 3 times higher than that of HbA1c. However, in type 1 diabetic patients, we often find an even higher GA/HbA1c ratio of nearly 3.5. Therefore, this study was performed to examine the significance of a higher GA/HbA1c ratio. METHODS: 17 type 1 diabetic patients were enrolled in part 1 of the study and divided into two groups, one with a higher and the other with a lower GA/HbA1c ratio. In both groups, the correlation between GA or HbA1c level and each "4-point" capillary glucose level was analyzed. 80 type 1 diabetic patients were enrolled in part 2 of the study and the relationship between mean GA/HbA1c ratio in the past year and degree of diabetic retinopathy was analyzed. RESULTS: In part 1 of the study, we found positive correlations between GA and bedtime capillary glucose levels and between HbA1c and bedtime capillary glucose levels in the higher GA/HbA1c group (r = 0.86, p = 0.023; r = 0.95, p = 0.012, respectively), but not in the lower GA/HbA1c group. In part 2 of the study, a significant positive correlation between GA/HbA1c ratio and severity of retinopathy could be observed (r = 0.269, p = 0.017). CONCLUSIONS: A higher GA/HbA1c ratio may reflect a postprandial hyperglycemic state and simultaneous monitoring of GA and HbA1c may improve the management of diabetic patients.

Aims/Introduction To evaluate the efficacy and safety of once‐weekly (q.w.) extended‐release exenatide after switching from twice‐daily (b.i.d.) exenatide in patients with type 2 diabetes. Materials and Methods This was an investigator‐initiated, prospective, single‐arm, multicenter study. Individuals with type 2 diabetes who had been treated with exenatide b.i.d. for at least 3 months were enrolled and switched to exenatide q.w. for 24 weeks. The primary end‐point was change in HbA1c at week 24 to test the glucose‐lowering effect of exenatide q.w. versus exenatide b.i.d. Results A total of 58 Japanese individuals with type 2 diabetes completed the study. Glycated hemoglobin was reduced by 0.2% at week 24 (7.2 ± 1.2% vs 7.0 ± 1.2% [56 ± 13 vs 53 ± 13 mmol/mol], 95% confidence interval −0.4 to −0.03%, P < 0.005 for non‐inferiority, P = 0.01 for superiority). Fasting plasma glucose was reduced by 12 mg/dL at week 24 (154 ± 46 vs 142 ± 46 mg/dL, P = 0.02). β‐Cell function assessed by homeostasis model assessment of β‐cell function and C‐peptide index was significantly improved at week 24. The incidence of self‐reported hypoglycemia was reduced, and treatment satisfaction assessed by the Diabetes Treatment Satisfaction Questionnaire and Diabetes Medication Satisfaction Questionnaire was improved at week 24, with no change in body weight. There was no serious adverse event related to the study drug. Conclusions Switching from exenatide b.i.d. to exenatide q.w. resulted in a reduction in glycated hemoglobin, fasting plasma glucose and the incidence of hypoglycemia, and improvement in β‐cell function and treatment satisfaction in patients with type 2 diabetes. These findings will be useful for selecting optimal treatment in individuals with type 2 diabetes.

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