Does serum 1,5-anhydroglucitol establish a relationship between improvements in HbA1c and postprandial glucose excursions? Supportive evidence utilizing the differential effects between biphasic insulin aspart 30 and insulin glargine

A. C. Moses, Philip Raskin, N. Khutoryansky

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Aim: To investigate the relationship between changes in glycated haemoglobin (HbA1c) and postprandial glucose excursions on 1,5-anhydroglucitol (1,5-AG) in patients with Type 2 diabetes, utilizing the differential effects between biphasic insulin aspart 30 (BIAsp 30) or insulin glargine (IGlar) on postprandial glucose (PPG) levels. Methods: 1,5-AG was measured using the GlycoMark® assay at baseline and after 12 and 28 weeks in the INITiation of Insulin to reach HbA1c Target (INITIATE) study of 233 patients randomized to either BIAsp 30 or IGlar. Results: Baseline 1,5-AG was low and not significantly different (4.9 ± 3.5 and 4.3 ± 2.6 μg/ml in the BIAsp 30 and IGlar groups, respectively). After 28 weeks, the levels of 1,5-AG were higher in the BIAsp 30 than in the IGlar group (13.4 vs. 11.1 μg/ml, P = 0.008) and change from baseline was 25% greater with BIAsp 30 than IGlar (8.4 vs. 6.7 μg/ml, P = 0.011). 1,5-AG levels increased as a function of decreasing HbA1c or the average change in postprandial plasma glucose (PPGave) with significant relationships for 1,5-AG/ HbA1c vs. HbA1c or 1,5-AG/PPGavevs. PPG ave (both P < 0.0001), respectively. Conclusions: As reported in previous publications, 1,5-AG reflects ambient glycaemic control and increases with reductions in HbA1c and postprandial glucose. The greater reductions in postprandial excursion achieved with BiAsp 30 compared with glargine were associated with greater increases in 1,5-AG. Even moderate elevations in HbA1c substantially lower 1,5-AG, suggesting that it can be most discriminating in identifying patients with excessive postprandial glucose excursions at HbA1c levels that approach the upper end of the normal range.

Original languageEnglish (US)
Pages (from-to)200-205
Number of pages6
JournalDiabetic Medicine
Volume25
Issue number2
DOIs
StatePublished - Feb 1 2008

Keywords

  • Basal
  • Glycaemic control
  • Insulin analogues
  • Target
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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