1,5-Anhydro-D-Glucitol Could Reflect Hypoglycemia Risk in Patients with Type 2 Diabetes Receiving Insulin Therapy

• Published in: Endocrinology and metabolism (Seoul) Vol. 31; no. 2; pp. 284 - 291
• Main Authors: Kim, Min Kyeong, Jung, Hye Seung, Kwak, Soo Heon, Cho, Young Min, Park, Kyong Soo, Kim, Seong Yeon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Endocrine Society 01.06.2016; 대한내분비학회
• Subjects: 1,5-Anhydroglucitol; Continuous glucose monitoring system; Diabetes mellitus, Type 2; Glycemic variability; Hypoglycemia; Original; 내과학; Diabetes mellitus, Type 2; Glycemic variability; Hypoglycemia; 1,5-Anhydroglucitol; Continuous glucose monitoring system
• ISSN: 2093-596X; 2093-5978
• DOI: 10.3803/EnM.2016.31.2.284

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. 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). 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). 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.