Excretion rates of 1,5-anhydro-D-glucitol, uric acid and microalbuminuria as glycemic control indexes in patients with type 2 diabetes

Abstract

1,5-anhydroglucitol (1,5-AG), uric acid and urinary proteins are excreted into the urine with increasing glucosuria. In the present retrospective study we analyzed whether these factors could be used as indicators for type 2 diabetes mellitus (T2DM) glucose control in 6,766 (T2DM) patients. There were 3,988 cases (58.9%) with HbA1c ≤ 6.5%, 853 cases (12.61%) with HbA1c levels ranging from 6.5% to 7% and 1,925 cases (28.5%) with HbA1c > 7%. HbA1c percentages were correlated with age, MA and 1,5-AG serum concentrations (P < 0.001). The serum uric acid concentration (P < 0.001) was significantly lower in elevated MA (P < 0.001) and 24-hour urinary protein (P = 0.024) patients. Hb1Ac percentages (P < 0.001) were significantly enhanced in patients with 1,5-AG serum concentrations ≤10 mg/L compared to >10 mg/L. With a derived receiver operating characteristic (ROC) curve, a 1,5-AG cut-off value of 11.55 mg/L for hyperglycemia could be diagnosed with a specificity of 71.2 (69.7–72.6) and a sensitivity of 75.3 (73.6–76.9). The serum 1,5-AG concentration is a marker for hyperglycemia and may be particularly useful as an indicator for short-term glycemic excursions in order to improve treatments in T2DM patients.

Continuous subcutaneous insulin infusion combined with liraglutide reduced glycemic variability and oxidative stress in type 2 diabetes mellitus: a study based on the flash glucose monitoring system

“…1) showed that the addition of liraglutide improved glycemic control compared with CSII alone, manifested by decreased FBG and estimated HbA1c. As previous studies have shown, 1,5-AG is a new clinical marker for glycemic control in patients with type 2 diabetes [23,24]. In this study, we found that the serum 1,5-AG concentration in the CSII combined with liraglutide group was significantly higher than that in the CSII alone group (Table 2), which may further imply that glycemic control with CSII combined with liraglutide is better than with CSII.…”

Impact of serum 1,5-anhydro-d-glucitol level on the prediction of severe coronary artery calcification: an intravascular ultrasound study

“…No differences in 1,5-AG levels were found in patients with markedly different estimated glomerular filtration rates [18], and these levels were not influenced by administration of a gliptin compound [19]. Serum 1,5-AG concentration is a marker for hyperglycemia and may be particularly useful as an indicator for short-term glycemic excursions [20] and is significantly higher in DM patients [21]. Finally, 1,5-AG might suppress the blood glucose elevation through inhibition of sucrase and intestinal glucose absorption [22].…”

Diagnostic value of glycemic markers HbA1c, 1,5-anhydroglucitol and glycated albumin in evaluating gestational diabetes mellitus

“…There are reports showing that controlling blood glucose in the nonfasting state, especially in the postprandial period can reduce the risk of diabetic complications. 10,11 Given the presence of dysglycemic individuals who are only postprandial hyperglycemia, serum 1,5-AG may be a useful marker of diabetes. 7 Recent evidence shows that plasma concentrations of 1,5-AG show decreases at the highest levels of blood glucose and reflect glucose excursions.…”

“…10 These observations support the usefulness of 1,5-AG as a marker of short-term glycemic variability for the assessment and preventing of GDM complications. 11 The strength of our study is the inclusion of 1 h glucose values. In some previous studies using different diagnostic criteria 1 h glucose values were not available.…”

“…-AG) provides insight into patients' short-term (approximately 3-7 days) glycemic status. 7,[9][10][11] Serum 1,5-AG levels rapidly change inversely related to glucose variations. Increased blood glucose levels inhibit reabsorption from kidney tubules by competing with 1,5-AG.…”