Plasma anhydro-D-glucitol (1,5-AG) as an indicator of hyperglycaemic excursions in pregnant women with diabetes.
OBJECTIVE
To evaluate the use of the plasma 1,5-anhydro-d-glucitol (1,5-AG) level as a possible marker for glucose excursions in pregnant women with diabetes.


METHODS
The study group consisted of 55 pregnant women with diabetes (gestational diabetes mellitus-GDM, n = 28 or pre-gestational diabetes mellitus -PGDM, n = 27), without hepatic or renal insufficiency, gestational age range 5-38 weeks. In each patient, 24-h glucose profile, glycated haemoglobin and 1,5-AG plasma levels were measured. Mean blood glucose (MBG) and M-value (by Schlichtkrull) were calculated. MBG, M-value and maximal daily glycaemia (MxG) were used as indexes of daily glycaemic excursions.


RESULTS
A significant correlation was found between the 1,5-AG plasma level and MxG [r = (-0.3)] and between the 1,5-AG level and M-value [r = (-0.36)]. There was no association between the 1,5-AG level and gestational age. Multivariate regression analysis, with 24-h glucose profile, gestational age and MxG as independent variables, showed that MxG was the main parameter determining the 1,5-AG plasma level [beta = (-0.68)]. The M-value, the coefficient of glucose fluctuations, also determined the 1,5-AG level but with lower statistical power [beta = (0.41)]. No statistical differences were found in the group with HbA(1c) < 6% or > 6% for 1,5-AG and M-value, while MBG was higher in poorly controlled patients (HbA(1c) > 6%).


CONCLUSIONS
The plasma 1,5-AG level may be a useful marker of daily glucose excursion in pregnant women with diabetes, as an adjunct to HbA(1c) monitoring.
Dworacka
M
M
Department of Pharmacology, Poznan University of Medical Sciences, Polna, Poznan, Poland. mdworac@am.poznan.pl
Wender-Ozegowska
E
E
Winiarska
H
H
Borowska
M
M
Zawiejska
A
A
Pietryga
M
M
Brazert
J
J
Szczawinska
K
K
Bobkiewicz-Kozłowska
T
T
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D003847:Deoxyglucose / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*
D015415:Biomarkers; D001786:Blood Glucose; D003847:Deoxyglucose; D006442:Glycated Hemoglobin; C006584:1,5-anhydroglucitol