Dispersion of serum 1,5 anhydroglucitol values in patients with type 2 diabetes at goal of HbA1c

Aim: To investigate the relationship of 1,5 anhydroglucitol (1,5 AG) with HbA1c in patients with type 2 diabetes (T2D) with different ranges of glycemic control. Methods: One hundred outpatients with T2D ≥ 18 years old were studied. In addition, HbA1c, glycemia, 1,5 AG, lipids, albuminuria, estimated glomerular filtration rate, and clinical data were registered. Results: The patient's median age was 62.5 years, with a median of 10 years with T2D. Those with HbA1c < 7 % had higher 1,5 AG than those with HbA1c ≥ 7 %, 16.8 ug/ml vs. 4.90 (p = 0.00001). 1,5 AG correlated inversely with HbA1c (r = -0.7910, p = 0.00001), glycemia (r = -0.6307, p = 0.00001), cholesterol (r = -0.2257, p = 0.0239), LDL-cholesterol (r = -0.2240, p = 0.0266), albuminuria (r = -0.3644, p = 0.0002) and heart rate (r = -0.267, p = 0.0072). Those on insulin therapy also had lower 1,5 AG (p = 0.000). The scatter plot of 1,5 AG and HbA1c fitted a second-degree fractional polynomic regression model, with dispersion of 1 5 AG when HbA1c < 7.5%. An HbA1c ≥ 7.5 % predicted a 1,5 AG < 10 ug/ml. Conclusion: Dispersion of 1,5 AG values at HbA1c < 7.5 % indicates postprandial glucose excursions that may impair glucose control and increase the cardiovascular risk in these patients.