Increased 1,5-anhydroglucitol predicts glycemic remission in patients with newly diagnosed type 2 diabetes treated with short-term intensive insulin therapy.
BACKGROUND
Short-term intensive insulin therapy has been shown to induce long-term glycemic remission in patients with newly diagnosed type 2 diabetes. However, predictors of remission are still uncertain. This study was conducted to evaluate whether changes of 1,5-anhydroglucitol (1,5AG) and fructosamine (FA) could be a predictor of remission.


METHODS
Newly diagnosed drug-naive patients with type 2 diabetes (n = 64) were enrolled. After baseline assessments, continuous subcutaneous insulin infusion (CSII) was administered in all patients until euglycemia was achieved and maintained for another 2 weeks. Patients were subsequently followed monthly for 3 months. 1,5AG and FA were measured before and after therapy and at 1-month follow-up.


RESULTS
After CSII, A1C and FA decreased from baseline, whereas 1,5AG increased. 1,5AG was higher at 1-month follow-up (11.5 ± 4.1 vs. 6.7 ± 2.8 mg/L, P<0.001), whereas FA was lower (273.1 ± 56.1 vs. 316.2 ± 39.3 μmol/L, P = 0.021) in the remission group. Stepwise logistic regression analysis showed that 1,5AG at 1-month follow-up rather than FA was an independent predictor of remission after adjusting for other confounders (odds ratio 1.56, 95% confidence interval [CI] 1.15-2.12, P = 0.004). The area under the curve of the receiver operating characteristic curve analysis was 0.85 (95% CI 0.75-0.96, P<0.001). The optimal cutoff point for 1,5AG at 1-month follow-up was 8.9 mg/L (specificity, 83.3%; sensitivity, 78.6%).


CONCLUSIONS
Improvement of 1,5AG predicts maintenance of glycemic remission after intensive insulin therapy in patients with newly diagnosed type 2 diabetes.
Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Liehua
L
Liu
Xuesi
X
Wan
Juan
J
Liu
Zhimin
Z
Huang
Xiaopei
X
Cao
Yanbing
Y
Li
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003847:Deoxyglucose / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D019270:Fructosamine / Q000097:blood*; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012074:Remission Induction; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D019270:Fructosamine; C006584:1,5-anhydroglucitol; D003847:Deoxyglucose