1,5-anhydro-D-glucitol: a novel marker of glucose excursions

In recent years a great deal of discussion has focused on postprandial hyperglycaemia as a risk factor for cardiovascular mortality. Routinely used parameters of metabolic control such as fasting plasma glucose (FPG) and HbA1c are not useful for determination of daily glucose excursions. 1,5-Anhydro-D-glucitol (1,5-AG) in human plasma has been proposed for several years as a short-term, retrospective marker of glycaemic control and seems to be the most suitable parameter for monitoring glucose excursions. The plasma level of 1,5-AG reflects acute episodes of hyperglycaemia more sensitively than HbA1c does and is correlated with FPG and postprandial hyperglycaemic peaks. The maximal glycaemic value observed in a patient ultimately determines the plasma 1,5-AG level. 1,5-AG could be helpful in detection of hyperglycaemic excursions, even in those patients with diabetes who self-monitor blood glucose and in those patients who are monitored routinely for FPG and HbA1c. In non-diabetic patients the plasma 1,5-AG level may serve as a screening marker for postprandial hyperglycaemia-associated cardiovascular risk.