Related Experiment Videos
Serum 1,5-Anhydroglucitol Identifies Residual Mortality Risk Beyond Time in Range in Type 2 Diabetes: A Cohort Study
Jiaying Ni1, Lei Chen2, Hang Su1,3
1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Journal of Diabetes
|August 4, 2026
Summary
Continuous glucose monitoring (CGM) time in range (TIR) and serum 1,5-anhydroglucitol (1,5-AG) independently predict mortality in type 2 diabetes. Low 1,5-AG identifies residual risk even when TIR targets are met.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Clinical Research
Background:
- Prognostic value of continuous glucose monitoring (CGM) metrics and glucose biomarkers for mortality in type 2 diabetes (T2D) requires further clarification.
- Residual risk assessment in T2D patients achieving glycemic targets needs enhanced predictive tools.
Purpose of the Study:
- To evaluate the combined prognostic value of CGM-derived time in range (TIR) and serum 1,5-anhydroglucitol (1,5-AG) for predicting mortality in T2D.
- To assess the independent and complementary roles of TIR and 1,5-AG in mortality risk stratification.
Main Methods:
- A cohort study of 3677 T2D patients with a median follow-up of 7.4 years.
- Cox proportional hazards models assessed associations of baseline TIR and 1,5-AG with all-cause and cardiovascular mortality.
- Analysis explored 1,5-AG's performance within TIR subgroups and compared it to CGM-derived glycemic variability metrics.
Main Results:
- TIR and 1,5-AG independently predicted mortality; concurrent low TIR and low 1,5-AG showed the highest risk (HR 1.82).
- Low 1,5-AG significantly increased mortality risk in patients with TIR >70% (HR 1.69), but not in those with TIR ≤70%.
- 1,5-AG improved risk prediction in patients achieving TIR targets; CGM glycemic variability metrics did not significantly associate with mortality.
Conclusions:
- Serum 1,5-AG and CGM-derived TIR provide independent and complementary prognostic information in T2D.
- Low 1,5-AG identifies patients at residual risk of mortality, even when glycemic targets (TIR) are achieved.
Related Concept Videos
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:15Diabetes: Symptoms, Diagnosis, and Complications
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...