Serum 1,5-Anhydroglucitol Concentration as a Biomarker for Type 1 Diabetes in Adults and Children.

BACKGROUND: Type 1 diabetes (T1D) is an autoimmune disease and the leading form of diabetes among young white people. 1,5-Anhydroglucitol (1,5-AG), a nontraditional biomarker of postprandial glycemic control (after 1 - 3 days to 2 weeks), may be useful in T1D screening. We studied serum 1,5-AG concentration as a potential biomarker for T1D screening and diagnosis in adults and children. METHODS: In this case-control study, adults (n = 121; age, 19 - 61 years) and children (n = 19; age, 8 - 14 years) with T1D were matched with healthy subjects (n = 242) according to gender and age. Serum 1,5-AG levels were measured enzymatically (GlycoMark Inc., NY, USA). RESULTS: Patients showed no symptoms of overt kidney disease, assessed by serum creatinine concentrations. The median (25th - 75th percentile) 1,5-AG concentrations for the control group compared with the T1D group were 155 (128 - 183) vs. 21 (14 - 34) µmol/L in adults and 190 (158 - 237) vs. 20 (12 - 30) µmol/L in children (p < 0.001 for both). Receiver operating characteristic curves showed that 1,5-AG cutoffs of ≤ 113 and ≤ 79 µmol/L for adult men and women, respectively, and ≤ 57 µmol/L for children of both genders had > 95% sensitivity and specificity for both groups. CONCLUSIONS: Our results suggest that serum 1,5-AG concentration may be useful as an adjunct measure of hyperglycemia for diagnosing T1D and has the potential to screen for T1D in high-risk subjects.

Data for serum 1,5 anhydroglucitol concentration in different populations.

1,5 anhydroglucitol (1,5-AG), is a nonmetabolized 1-deoxy form of glucose, originate mainly from the diet. 1,5-AG is a biomarker to detect and magnify hyperglycemic excursions (postprandial hyperglycemia) in diabetic patients. Concentrations of 1,5-AG has been applied as supporting biomarker to diagnosis of the major forms of diabetes (type 1, type 2, and gestational). The serum 1,5-AG reference interval is relevant to the appropriate clinical application of this biomarker. This article contains data regards to serum concentration of the biomarker primarily for healthy subjects, capture from the literature, in different populations. Correlation analysis between 1,5-AG and markers associated with diabetes and its complication were presented. The data was complementary to the study "Reference intervals for serum 1,5-anhydroglucitol in children, adolescents, adults, and pregnant women" (Welter et al., 2018). The data present in this article improve the comparisons for 1,5-AG in different conditions and methodologies.

Reference intervals for serum 1,5-anhydroglucitol in children, adolescents, adults, and pregnant women.

BACKGROUND: 1,5-anhydroglucitol (1,5-AG) is a validated marker of short-term glycemic control. We determined the reference intervals of 1,5-AG in different age groups and during pregnancy. METHODS: Blood samples were collected from 2303 Euro-Brazilian healthy subjects: 580 children, 496 adolescents, 922 adults matched by age and sex, and 305 pregnant women in four gestational periods. Serum 1,5-AG was measured using an enzymatic reagent in an automated system. RESULTS: The calculated reference intervals (nonparametric, 2.5th-97.5th) for males and females were, respectively: children, 96-302 and 89-277 µmol/l; adolescents, 84-311 and 79-277 µmol/l; and adults, 80-260 and 62-241 µmol/l. Males consistently showed significantly higher concentrations than females. 1,5-AG reference intervals in pregnant women were 56-298 µmol/l at <23 weeks gestation (n = 110), 37-166 µmol/l at 24-28 weeks gestation (n = 106), 34-155 µmol/l at 29-32 weeks gestation (n = 52), and 33-246 µmol/l at >32 weeks gestation (n = 37). No significant differences in 1,5-AG concentration were observed between non-pregnant and pregnant women at <23 weeks of gestation. A negative correlation (r = -0.287; p < .001) between 1,5-AG concentration and age was observed. CONCLUSIONS: The reference intervals for 1,5-AG were affected by sex and age.

The Blood Bank for Diabetes Screening: a Feasible Alternative?

BACKGROUND: Vascular complications of diabetes mellitus (DM) are associated with 5% of deaths globally every year. Early diagnosis and treatment could reduce this figure. The aim of this project was to investigate the frequency of undiagnosed DM among blood donors and the possibility of blood banks participating in DM screening. METHODS: Of the approximate 5,600 candidates for blood donation who were evaluated, 4,601 were considered suitable. Candidates with any type of DM, hypertension, thyroid disease, and/or continuous use of any drugs were excluded, resulting in the participation of 635 donors aged 18 - 69 years. Glycated hemoglobin (HbA1c) levels were used to classify the donors: HbA1c < 5.7% (low risk of DM), HbA1c 5.7 - 6.4% (pre-diabetes), and HbA1c ≥ 6.5% (diabetes). Another subsample (n = 576) that excluded donors with HbA1c levels < 5.0% or > 6.5% were classified according to the risk of developing DM in 5 years: HbA1c 5 - 5.5% (low risk, < 9%), HbA1c 5.6 - 6.0% (moderate risk, 9 - 25%), and HbA1c 6.1 - 6.5% (high risk, 26 - 50%). RESULTS: Three donors (0.5%) had HbA1c levels suggestive of DM, and 57 donors (9.0%) had levels associated with pre-DM. Regarding the risk of developing DM in 5 years, 111 donors (19.3%) were classified at moderate risk, and 10 donors (1.7%) were classified at high risk. CONCLUSIONS: DM screening in blood banks using HbA1c can identify new cases of DM and individuals at an increased risk of DM. In summary, blood banks could participate in DM screening, benefitting the general public and public health care system in Brazil.