• 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

１０．Combination measurement with 1,5-AG and HbA1c

  Combined measurement of both markers is useful for the selection of the treatment in diabetic patients.

Algorithm for the treatment of diabetics based on using 1,5-AG and HbA1c

  For example, if a patient shows 1,5-AG of less than 10μg/ml despite HbA1c level of 6%, α-GI, glinides, GLP１-related drugs and rapid-acting insulins will be recommended for treating glucose spike.

  If a patient shows 1,5-AG of more than 10μg/ml and HbA1c level of 7%, it is reasonable to start or increase sulfonylurea, metformin, pioglitazone and long-acting insulins for lowering between-meals glucose.

  α-GI which specializes in lowering glucose spikes usually increase 1,5-AG value more than 14μg/ml in spite of remaining HbA1c in high level.

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