The Application of Plasma 1,5-anhydro-D-glucitol for Monitoring Type 2 Diabetic Patients

Aim: Recent data have suggested that effective control of postprandial blood glucose can reduce the risk of macroangiopathic complications of diabetes, especially cardiovascular risk. 1,5-Anhydro-D-glucitol (1,5-AG) has been proposed as a marker of short-term hyperglycaemic excursions. We aimed to evaluate its usefulness in patients with type 2 diabetes and have attempted to indicate when 1,5-AG monitoring should be used in ordinary diabetes care settings.

Methods: The study group consisted of 130 type 2 diabetic patients aged 36-69 years. 1,5-AG plasma level, HbA_1c concentrations and daily glucose profile were measured. Mean blood glucose (MBG), M-value were calculated and maximal daily glycaemia (MxG) was established as indicators of short-term hyperglycaemic episodes.

Results: 1,5-AG plasma level was negatively and HbA_1c was positively correlated with fasting glycaemia (FG), MBG, M-value and MxG. Multivariate regression analysis revealed that 1,5-AG plasma level is determined by MxG only, while FG determined HbA_1c concentration in blood. The analysis of 1,5-AG level and HbA_1c distributions in well and poorly controlled patients revealed that persons with low HbA_1c values may have decreased 1,5-AG plasma level.

Conclusion: 1,5-AG plasma level monitoring is the useful method to identify well controlled, exclusively based on HbA_1c levels type 2 diabetic patients with transient hyperglycaemia, accordingly patients at high risk of macroangiopathic complications.