By Ric Susman
ORLANDO, Fla -- May 21, 2008 -- The blood marker 1,5-anhydroglucitol appears to be useful as a complement to haemoglobin (Hb) A1C in helping doctors analyse postprandial glucose in patients with diabetes, according to researchers presenting here at the American Association of Clinical Endocrinologists (AACE) 17th Annual Meeting and Clinical Congress.
The marker, researchers suggested, could help physicians better treat patients using newer drugs that target postprandial glucose.
Steve Wittlin, MD, Clinical Director of Endocrinology, University of Rochester Medical Center, Rochester, New York, and colleagues retrospectively analysed the use of 1,5-anhydroglucitol to monitor exenatide, pramlintide, sitagliptin, and biphasic insulin, specifically looking at how Hb A1C and anhydroglucitol responded to glucose after consumption of a meal.
The test does not provide specific information on blood glucose performed right after meals, Dr. Wittlin noted, although the Hb A1C test provides important information about how blood glucose has behaved over the preceding 2 or 3 months. Recent evidence suggests that controlling after-meal glucose levels plays a significant role in achieving optimal glycaemic control and reducing the burden of cardiovascular complications.
Specifically, Dr. Wittlin's team reviewed data from the Efficacy and Safety of Sitagliptin Monotherapy in Japanese Patients With Type 2 Diabetes trial, which enrolled 151 patients with type 2 diabetes. The patients were observed over a course of 12 weeks. Doctors monitored the changes seen in postmeal glucose (in patients receiving one of the newer drugs that target postprandial glucose as well as control subjects), comparing Hb A1C with 1,5-anhydroglucitol.
"Although 2-hour postprandial glucose decreased by 69.2 mg/dL in the sitagliptin group, Hb A1C changed only 8.6% in absolute percentage change," Dr. Wittlin observed in a poster presentation on May 17. "This is compared with a percentage change of 83% when using 1,5-anhydroglucitol."
The substantial increase seen when 1,5-anhydroglucitol was used is consistent with a marked decrease in postprandial [glucose] excursion observed during meal-tolerance tests. The difference was highly statistically significant (P < .001).
The blood marker 1,5-anhydroglucitol has been approved by the US Food and Drug Administration for monitoring intermediate glycaemic control by measuring the levels of a monosaccharide 1,5-anhydroglucitol in blood.
"There are several clinical studies using 1,5-anhydroglucitol that are ongoing," Dr. Wittlin concluded. "As such, 1,5-anhydroglucitol may be a useful complement to Hb A1C to reflect postprandial glucose in diabetic patients treated with agents that target postprandial glucose."
The blood marker 1,5-anhydroglucitol is being commercialised by a partnership between Toyota Tsusho America, New York, New York; Nippon Kayaku, Tokyo, Japan; and the BioMarker Group, Kannapolis, North Carolina.
[Presentation title: The Use of 1,5-Anhydroglucitol (GlycoMark) to Monitor New Classes of Therapies for Managing Postmeal Glucose in Patients With Diabetes. Abstract 226]
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