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1,5-Anhydroglucitol (1,5-AG)


Definition


  • 1,5-Anhydroglucitol (1,5-AG), sometimes known as GlycoMark, is a monosaccharide that shows a structural similarity to glucose. Its main source in humans is dietary ingestion, particularly meats and cereals. In addition, 10% of 1,5-AG is derived from endogenous synthesis. It is generally not metabolized, and in healthy subjects, it achieves a stable plasma concentration that reflects a steady balance between ingestion and urinary excretion.

  • Normal range: 10.7 " “32.0 Ž ¼g/mL in males; 6.8 " “29.3 Ž ¼g/mL in females.


Use


  • Used clinically to monitor short-term glycemic control in patients with diabetes (1 " “2 weeks)

  • Useful marker for postprandial hyperglycemia

  • Performs better than hemoglobin A1C for monitoring glucose profile in pregnancies complicated by type 1 diabetes


Interpretation


Increased In


  • 1,5-AG may be increased during IV hyperalimentation.


Decreased In


  • Individuals with renal glucose thresholds that are markedly different from 180 mg/dL (e.g., chronic renal failure, pregnancy, and dialysis) and in those undergoing steroid therapy.

  • α-Glucosidase inhibitors can decrease 1,5-AG by interfering with its intestinal absorption.


Limitations


  • In patients with poorly controlled DM, 1,5-AG is less sensitive to modest changes in glycemic control because of continuous glycosuria.

  • Levels can be influenced by factors such as dairy product, races, uric acid, triglycerides, liver disease, gastrectomy state, and cystic fibrosis.

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