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

OBJECTIVE — Postprandial hyperglycemia is often inadequately assessed in diabetes man-agement. 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 subopti-mally controlled patients with diabetes. RESEARCH DESIGN ANDMETHODS — Patients with type 1 or type 2 diabetes and an HbA1c (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 3.2 g/ml [means SD]) despite similar A1C (7.3 0.5%). Mean 1,5-AG (r 0.45, P 0.006) correlated with AUC-180 more robustly than A1C (r 0.33, P 0.057) or FA (r 0.38, P 0.88). MPMG correlated more strongly with 1,5-AG (r 0.54, P 0.004) than with A1C (r 0.40,