Reduction and Recovery of Plasma 1,5-Anhydro-D-Glucitol Level in Diabetes Mellitus

Abstract

The plasma concentration of 1,5-anhydro-D-glucitol (AG) was measured in 135 newly diagnosed patients who were referred for oral glucose tolerance tests. AG concentrations in the nondiabetic patients indicated that the mean value of normal AG concentration was 21.8 micrograms/ml (SD = 5.9 micrograms/ml, range 9.6-38.8 micrograms/ml). This distribution of AG concentration was significantly different from that in patients with impaired glucose tolerance (IGT) (13.3 +/- 5.4 micrograms/ml) and definitely different from that in diabetic patients (2.1 +/- 1.8 micrograms/ml). In a standard glucagon test, it was suggested that the decrease of plasma AG was affected not only by glycemic control of the patients but also by pancreatic cell secretory activity. The reduction of AG concentration was more marked in IDDM patients than in NIDDM patients. In longitudinal studies, AG concentration was shown to be sensitive to glycemic control. However, its recovery showed a tendency toward much delay after the improvement of fasting blood glucose or HbA1 concentrations. On the other hand, AG concentration showed negligible diurnal change and no immediate change as a result of diet, oral glucose load, or acute shift of the insulin level in both normal and diabetic subjects.

Urinary excretion of 1,5-anhydro-D-glucitol accompanying glucose excretion in diabetic patients

“…A pyranoid polyol resembling glucose, 1,5-anhydro-Dglucitol (AG), is a humoral component in humans and other mammals [1][2][3][4][5][6][7][8][9][10][11][12]. The plasma AG concentration is specifically reduced in diabetes mellitus [10] and shows several dynamic properties which are advantageous as a clinical marker for diabetes mellitus.…”

“…The plasma AG concentration is specifically reduced in diabetes mellitus [10] and shows several dynamic properties which are advantageous as a clinical marker for diabetes mellitus. First, the extent of the plasma AG reduction is apparently correlated with the severity of diabetes mellitus, and strict metabolic control can reverse this reduction [11]. Second, AG undergoes very slow turnover in vivo [8,12], and its plasma concentration remains stable over a 24-h period, showing little acute response to fasting, food intake, and insulin administration [11].…”

“…The plasma AG concentration was determined by gas-liquid chromatography, as described previously [11]. The uri-"~ nary AG concentration was determined by a recently elaborated "~ 40 method using gas chromatography/mass spectrometry [12].…”

“…This correlation was more markedly demonstrated during a 100-g oral glucose tolerance test: parallel changes were observed in the concentrations of 1,5-anhydro-D-glucitol and glucose in the urine collected every hour after the glucose load. These observations led to the proposal that low plasma concentration of this polyol, which is observed in diabetes mellitus, may be the result of a frequent and/or prolonged high blood glucose concentration beyond the renal threshold for glucose excretion.Key words: 1,5-anhydroglucitol, urinary excretion, reabsorption, glucosuria, hyperglycaemia.A pyranoid polyol resembling glucose, 1,5-anhydro-Dglucitol (AG), is a humoral component in humans and other mammals [1][2][3][4][5][6][7][8][9][10][11][12]. The plasma AG concentration is specifically reduced in diabetes mellitus [10] and shows several dynamic properties which are advantageous as a clinical marker for diabetes mellitus.…”

“…First, the extent of the plasma AG reduction is apparently correlated with the severity of diabetes mellitus, and strict metabolic control can reverse this reduction [11]. Second, AG undergoes very slow turnover in vivo [8,12], and its plasma concentration remains stable over a 24-h period, showing little acute response to fasting, food intake, and insulin administration [11]. Finally, AG also shows chemical and biochemical stability [12], and accordingly, we found no significant limitation on the storage and transport of plasma samples for AG determination.…”