• １．Improvement of glucose spike (postprandial hyperglycemia ) can not be sufficiently detected by HbA1c or glycoalbumin (fructosamine)
• ２．Why only 1,5-anhydroglucitol(1,5-AG) can detect glucose spike?
• ３．Measuring 1,5-AG weekly, monthly, even yearly is effective in management of diabetes mellitus
• ４．1,5-AG of less than 14 μg/ml indicates existence of glucose spike even in near-normoglycemia
• ５．Rapid and wide variations of 1,5-AG make your clinical decision robust
• ６．Follow up on development of hyperglycemia in subjects with impaired glucose tolerance (IGT)
• ７．"Your glycemia is stable" → No!!
• ８．The value of approximate mean postmeal maximum plasma glucose levels corresponding to 1,5-AG
• ９．Hypoglycemia and 1,5-AG
• １０．Combination measurement with 1,5-AG and HbA1c
• １１．Factors that cause an abnormal value
• １２．What is 1,5-Anhydroglucitol (1,5-AG ) ?
• １３．Physiological role
• １４．1,5-AG and diabetic complications

４．1,5-AG of less than 14 μg/ml indicates existence of glucose spike even in near-normoglycemia

  It has been reported 1,5-AG showed relatively low levels in response to glucose excursion or glucose spike in patients with similar HbA1c levels (Metabolism41,862,1992, Diabetes Care 18,1156,1995, Lancet 347,1514,1996).

  Continuous glucose monitoring system (CGM) performed by Dr. M. Dungan et al. showed that the lower level of 1,5-AG expected by the value of HbA1c indicated frequent and wide excursion of glycemia even in diabetic patient whose HbA1c was near-normal.

  1,5-AG was especially related to mean postmeal maximum glucose(MPMG), glucose spike.Glucose spikes can exist independently apart from normal mean blood glucose. ＧＲＡＤＥ score obtained from CGM is very well correlated with 1,5-AG. The parameter shows percentage of plasma glucose falling between 70 and 140 mg/dl.

  The value of standard deviation (SD) meanwhile shows high relationship to mean blood glucose. The matter demands great caution in handling correlation coefficient between one variable and SD.

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