1,5-Anhydro-D-Glucitol Could Reflect Hypoglycemia Risk in Patients with Type 2 Diabetes Receiving Insulin Therapy.
10.3803/EnM.2016.31.2.284
- Author:
Min Kyeong KIM
1
;
Hye Seung JUNG
;
Soo Heon KWAK
;
Young Min CHO
;
Kyong Soo PARK
;
Seong Yeon KIM
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. junghs@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Hypoglycemia;
1,5-Anhydroglucitol;
Diabetes mellitus, Type 2;
Glycemic variability;
Continuous glucose monitoring system
- MeSH:
Adult;
Blood Glucose;
Diabetes Mellitus, Type 2;
Glucose;
Humans;
Hyperglycemia;
Hypoglycemia*;
Insulin*
- From:Endocrinology and Metabolism
2016;31(2):284-291
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The identification of a marker for hypoglycemia could help patients achieve strict glucose control with a lower risk of hypoglycemia. 1,5-Anhydro-D-glucitol (1,5-AG) reflects postprandial hyperglycemia in patients with well-controlled diabetes, which contributes to glycemic variability. Because glycemic variability is related to hypoglycemia, we aimed to evaluate the value of 1,5-AG as a marker of hypoglycemia. METHODS: We enrolled 18 adults with type 2 diabetes mellitus (T2DM) receiving insulin therapy and assessed the occurrence of hypoglycemia within a 3-month period. We measured 1,5-AG level, performed a survey to score the severity of hypoglycemia, and applied a continuous glucose monitoring system (CGMS). RESULTS: 1,5-AG was significantly lower in the high hypoglycemia-score group compared to the low-score group. Additionally, the duration of insulin treatment was significantly longer in the high-score group. Subsequent analyses were adjusted by the duration of insulin treatment and mean blood glucose, which was closely associated with both 1,5-AG level and hypoglycemia risk. In adjusted correlation analyses, 1,5-AG was negatively correlated with hypoglycemia score, area under the curve at 80 mg/dL, and low blood glucose index during CGMS (P=0.068, P=0.033, and P=0.060, respectively). CONCLUSION: 1,5-AG level was negatively associated with hypoglycemia score determined by recall and with documented hypoglycemia after adjusting for mean glucose and duration of insulin treatment. As a result, this level could be a marker of the risk of hypoglycemia in patients with well-controlled T2DM receiving insulin therapy.
