Plasma 1,5-Anhydro-D-Glucitol as New Clinical Marker of Glycemic Control in NIDDM Patients

Yamanouchi, Toshikazu; Minoda, Susumu; Yabuuchi, Masahiko; Akanuma, Yasuo; Akanuma, Hiroshi; Miyashita, Hideo; Akaoka, Ieo

doi:10.2337/diab.38.6.723

Cited by 108 publications

(95 citation statements)

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“…Afterwards the enzymes have been found to be widespread in the biological world. 101,[106][107][108] The pathway for lyase action is outlined in Fig. 15.…”

Section: Reaction Mechanism Of Exo--14-glucan Lyasementioning

confidence: 99%

A Historical Perspective for the Catalytic Reaction Mechanism of Glycosidase; So As to Bring about Breakthrough in Confusing Situation

Chiba

2012

Bioscience, Biotechnology, and Biochemistry

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Various catalytic reaction models have been proposed as the reaction mechanisms of glycosidases, but a reasonable and unitary model capable of interpreting both ''inverting'' and ''retaining'' glycosidase reactions remains to be established. As for the models proposed to date, the nucleophilic displacement mechanism and the oxocarbenium ion intermediate mechanism are widely known, but recently the former is widely accepted, and so the general tendency of world opinion appears to favor it. This reaction model, however, is considered to comprise some inconsistencies that cannot be neglected from the viewpoint of reactivity in organic chemistry. While the nucleophilic displacement mechanism is often applied to reactions of glycosidases, it appears unlikely that such reactions actually occur. This review argues that the oxocarbenium ion intermediate reaction mechanism is more rational than the nucleophilic displacement reaction mechanism, as the action mode of glycosidases and related enzymes.

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“…Afterwards the enzymes have been found to be widespread in the biological world. 101,[106][107][108] The pathway for lyase action is outlined in Fig. 15.…”

Section: Reaction Mechanism Of Exo--14-glucan Lyasementioning

confidence: 99%

A Historical Perspective for the Catalytic Reaction Mechanism of Glycosidase; So As to Bring about Breakthrough in Confusing Situation

Chiba

2012

Bioscience, Biotechnology, and Biochemistry

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“…7 1,5-AG competes with glucose for reabsorption in the renal tubules. 7,8 Plasma 1,5-AG levels therefore decrease in the hyperglycemic state in which glycosuria is present. 1,5-AG is very sensitive, changes rapidly, and is known to reflect glycemic variability within a few days.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Glycemic Variability in Well-Controlled Type 2 Diabetes Mellitus

Chon

Lee²,

Fraterrigo³

et al. 2013

Diabetes Technology & Therapeutics

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Aims: It is necessary to evaluate glucose variability and postprandial hyperglycemia in patients with well-controlled type 2 diabetes mellitus because of the limitations associated with hemoglobin A1c (HbA1c) measurements. We evaluated parameters reflecting postprandial hyperglycemia and glycemic variability in patients with optimal HbA1c. Patients and Methods: Thirty-nine patients with HbA1c levels below 7% were recruited to the study. A continuous glucose monitoring system (CGMS) was applied for two 72-h periods. 1,5-Anhydroglucitol (1,5-AG) and fructosamine (FA) were measured as parameters for postprandial hyperglycemia and glucose variability. Using CGMS data, the following postprandial hyperglycemia parameters were calculated: mean postprandial maximum glucose (MPMG) and area under the curve for glucose above 180 mg/dL (AUC-180). To measure glycemic variability, we calculated mean amplitude of glucose excursion (MAGE) using a classical (MAGE c ) and new method (MAGE group of sign [MAGE gos ]). Results: The baseline HbA1c level was 6.3 -0.3%. The mean MPMG was 10.34 -1.84 mmol/L, and the mean AUC-180 was 0.17 -0.23 mmol/L/day. The mean MAGE gos was 3.27 -1.29 mmol/L, and MAGE c was 4.30 -1.43 mmol/L, indicating glycemic variability in our patients. The mean levels of 1,5-AG and FA were 16.7 -7.4 lg/mL and 273.0 -22.5 lmol/L, respectively. In a correlation analysis, FA was significantly correlated with MPMG, AUC-180, MAGE gos , and MAGE c . In contrast, 1,5-AG was only correlated with AUC-180. Conclusions: This study demonstrated postprandial hyperglycemia and glycemic variability in subjects with well-controlled diabetes. FA may reflect postprandial hyperglycemia and glycemic variability, but 1,5-AG may be of limited value for assessing glucose variability in patients with well-controlled type 2 diabetes mellitus.

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“…During normoglycemia, 1,5-AG is maintained at constant steadystate levels due to a large body pool compared with the amount of intake (10) and due to a lack of metabolism (10,11). Normally, in the kidneys, 1,5-AG is filtered and completely reabsorbed (12). However, with elevated serum glucose concentrations (generally Ͼ180 mol/l, the average renal threshold for glucose), glucose is not completely reabsorbed by the kidney, and serum 1,5-AG falls due to competitive inhibition of renal tubular reabsorption by glucose.…”

mentioning

confidence: 99%

1,5-Anhydroglucitol and Postprandial Hyperglycemia as Measured by Continuous Glucose Monitoring System in Moderately Controlled Patients With Diabetes

Dungan¹,

Buse

Largay³

et al. 2006

Diabetes Care

214

176

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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 Ϯ 3.2 g/ml [means Ϯ SD]) despite similar A1C (7.3 Ϯ 0.5%). Mean 1,5-AG (r ϭ Ϫ0.45, P ϭ 0.006) correlated with AUC-180 more robustly than A1C (r ϭ 0.33, P ϭ 0.057) or FA (r ϭ 0.38, P ϭ 0.88). MPMG correlated more strongly with 1,5-AG (r ϭ Ϫ0.54, P ϭ 0.004) than with A1C (r ϭ 0.40, P ϭ 0.03) or FA (r ϭ 0.32, P ϭ 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. Diabetes Care 29:1214 -1219, 2006T he importance of tight glycemic control in preventing the complications of diabetes has been well documented (1-3). More recently, studies indicate that postprandial glucose may be an independent risk factor for the development of macrovascular complications (4 -6). Many patients who are otherwise well controlled by HbA 1c (A1C), the current standard indicator of overall glycemia, also have significant postprandial hyperglycemia (7). Currently, available markers for measuring glycemic control, including A1C and fructosamine (FA), only reflect average glucose, potentially missing important hyperglycemic excursions that may be balanced out by hypoglycemia. Therefore, an alternative marker that robustly reflects postprandial glucose excursions could be useful in the management of patients with diabetes.Plasma 1,5-anhydroglucitol (1,5-AG) is a naturally occurring dietary polyol that has been proposed as a marker for postprandial hyperglycemia. An automated assay (Glycomark) has recently been approved in the U.S. as a short-term marker for glycemic control (8), and a similar assay has been in use in Japan for over a decade (9). During normoglycemia, 1,5-AG is maintained at constant steadystate levels due to a large body pool compared with the amount of intake (10) and due to a lack of metabolism (10,11). Normally, in the kidneys, 1,5-AG is filtered and completely reabsorbed (12). However, with elevated serum glucose concentrations (generally Ͼ180 mol/l, the average renal threshold fo...

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Plasma 1,5-Anhydro-D-Glucitol as New Clinical Marker of Glycemic Control in NIDDM Patients

Cited by 108 publications

References 0 publications

A Historical Perspective for the Catalytic Reaction Mechanism of Glycosidase; So As to Bring about Breakthrough in Confusing Situation

A Historical Perspective for the Catalytic Reaction Mechanism of Glycosidase; So As to Bring about Breakthrough in Confusing Situation

Evaluation of Glycemic Variability in Well-Controlled Type 2 Diabetes Mellitus

1,5-Anhydroglucitol and Postprandial Hyperglycemia as Measured by Continuous Glucose Monitoring System in Moderately Controlled Patients With Diabetes

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