Serum 1,5-anhydroglucitol (Glycomark™) levels in children with and without type 1 diabetes mellitus

Postprandial hyperglycemia associated with diabetes is a risk factor for cardiovascular disease. Currently, glycated hemoglobin A_1c (HgbA_1c) and glycated protein fructosamine are not sensitive markers for acute and short-term hyperglycemia. 1,5-Anhydroglucitol (1,5-AG) (Glycomark™; Tomen America, New York, NY, USA) is reported in adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) as a marker for postmeal hyperglycemia. However, the reference ranges for 1,5-AG in normal children and children with T1DM are not known. We studied 1,5-AG levels in 10 control children (6 males and 4 females) and 10 children with T1DM (7 males and 3 females). The levels of 1,5-AG in the normal controls were higher than those in children with T1DM (24.60 ± 3.99 μg/mL vs. 4.75 ± 2.95 μg/mL; p < 0.0001). There were no gender differences noted. The 1,5-AG levels were negatively correlated with HgbA 1c (r = -0.9366; p < 0.0001) and the peak postmeal plasma glucose concentrations (Pearson r = -7230; p = 0.0003). Our findings suggest that despite good glycemic control, postprandial glucose concentrations are elevated and that 1,5-AG showed a difference between controls and children with T1DM. The data are comparable with previous studies in normal adults and in those with T1DM and T2DM. They support the use of 1,5-AG concentrations, together with HgbA_1c, to evaluate therapy, especially to target postprandial hyperglycemia.