Also known as 1,5-AG, 1-deoxy-D-glucopyranose, 1,5-anhydroglucitol
1,5-Anhydroglucitol, also known as 1,5-AG, is a naturally occurring monosaccharide found in nearly all foods. Blood concentrations of 1,5-anhydroglucitol decrease during times of hyperglycemia above 180 mg/dL, and return to normal levels after approximately 2 weeks in the absence of hyperglycemia. As a result, it can be used for people with either type-1 or type-2 diabetes mellitus to identify glycemic variability or a history of high blood glucose even if current glycemic measurements such as hemoglobin A1c (HbA1c) and blood glucose monitoring have near normal values. Despite this possib
1,5-Anhydroglucitol, also known as 1,5-AG, is a naturally occurring monosaccharide found in nearly all foods. Blood concentrations of 1,5-anhydroglucitol decrease during times of hyperglycemia above 180 mg/dL, and return to normal levels after approximately 2 weeks in the absence of hyperglycemia. As a result, it can be used for people with either type-1 or type-2 diabetes mellitus to identify glycemic variability or a history of high blood glucose even if current glycemic measurements such as hemoglobin A1c (HbA1c) and blood glucose monitoring have near normal values. Despite this possible use and its approval by the FDA, 1,5-AG tests are rarely ordered. There is some data suggesting that 1,5-AG values are useful to fill the gap and offer complementary information to HbA1c and fructosamine tests.
== History == The role of 1,5-AG was first inferred by Akanuma in 1981 when he demonstrated decreased 1,5-AG levels in diabetic patients. This observation was enhanced in 1983 when it was seen that plasma 1,5-AG fell to undetectable levels in diabetic patients who did not receive insulin. Further studies showed that patients receiving medication to lower blood glucose had lasting improvement in 1,5-AG levels. If medication stopped, 1,5-AG decreased to pre-treatment levels. In 2003, 1,5-AG began to be looked at by researchers in the United States and was shown to be a valuable short-term glycemic monitor. In 2006, 1,5-AG showed its most compelling clinical use when it was demonstrated that an assay (GlycoMark, developed by Nippon Kayaku, Inc.) for postprandial hyperglycemia was able to differentiate two patients who had similar, near goal, hemoglobin A1c values, yet very different glucose profiles as shown by continuous blood glucose monitoring - one of the patients having excessive glycemic variability. In 2014, 1,5-AG in saliva was shown to mirror 1,5-AG in blood, indicating that it could be used as a noninvasive marker of short-term glycemic control.
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