Serum Levels Of 1,5‐Anhydro‐D‐Glucitol During The Normal And Diabetic Pregnancy And Puerperium

Abstract

In 25 normally non-pregnant women, 543 normally pregnant women and 75 pregnant women with diabetes mellitus or gestational diabetes mellitus, the relationship between the serum concentration of 1,5-anhydro-D-glucitol (1-deoxy-glucose) and carbohydrate metabolism was studied. The concentration of 1,5-anhydro-D-glucitol was estimated by means of gas-liquid chromatography. In normally non-pregnant women the concentration was found to be 18.6 +/- 5.2 mg/l (mean +/- SD). During the normal pregnancy, from 9 weeks of gestation, a steadily decreasing concentration was observed as the pregnancy progressed and the lowest value (10.2 +/- 4.6 mg/l) was found in the third trimester. After 5 days of puerperium the concentrations were found to be 10.8 +/- 3.7 mg/l. On the 30th day postpartum, the level was within the range for non-pregnant subjects. The values in pregnant women with diabetes mellitus and gestational diabetes mellitus were mostly below 10 mg/l throughout the entire pregnant period. The 1,5-anhydro-D-glucitol concentration was not affected by meals or oral glucose loading. A concentration below 10 mg/l was found in 36% of the normally pregnant women, where oral glucose tolerance tests and measurement of glycohemoglobin were shown to be within the normal range. The present study suggests that a change of 1,5-anhydro-D-glucitol level during pregnancy may reflect a mild alteration of carbohydrate metabolism that goes undetected by all the other diabetic indicators.

A computational model of 1,5-AG dynamics during pregnancy

“…The modeled 1,5‐AG results were superimposed over points derived from healthy, GDM, and DM patients (Tetsuo et al. 1990) to provide insight on the individual effect of each parameter on 1,5‐AG levels.…”

“…Superimposed data over time are from Tetsuo et al. 1990 (A) Iterations over k i , keeping the reabsorption fraction ( r ) at 0.9984. (B) Iterations over r , keeping k i at 5.…”

“…Glucose levels below 7.4 mmol/L fall within the range expected for nondiabetic patients, based on the superimposed data from Tetsuo et al. (1990). We see that a glucose level of 9 mmol/L corresponds closely with the data from pregnant diabetic individuals.…”

“…(1990). For the unfitted model (Adjusted Stickle), we used a glucose concentration of 8.9 mmol/L, from the mean maximal glucose concentration of third trimester type 1 diabetic subjects in an analysis by Nowak et al.…”

“…(1990), which evaluated serum concentrations of 1,5‐AG in 543 normal pregnant women and 75 pregnant women with GDM/DM. These data were used to compare the mathematical model to observed 1,5‐AG measurements.…”