Serum 1,5-anhydroglucitol is associated with diabetic retinopathy in Type 2 diabetes

Aims To determine whether there is a relationship between 1,5-anhydroglucitol (1,5-AG), a marker of postprandial hyperglycaemia and glycaemic variability, and the presence of diabetic retinopathy and albuminuria in patients with Type 2 diabetes. Methods Five hundred and sixty-seven patients with Type 2 diabetes (serum creatinine <133μmol/l), who were enrolled in the Seoul Metro-City Diabetes Prevention Program (SMC-DPP), were cross-sectionally assessed by multivariate logistic regression analysis. Results After controlling for age, sex, binary HbA_1c levels, duration of diabetes, triglyceride, systolic blood pressure, smoking status, history of hypertension and dyslipidaemia, and the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker medication, the odds ratios (95% CI) of diabetic retinopathy were 2.86 (1.12-7.25) for the first (lowest) quartile of 1,5-anhydroglucitol, 2.87 (1.25-6.61) for the second quartile and 0.88 (0.35-2.22) for the third quartile compared with the fourth quartile (P for trend=0.010). Conversely, the associations between 1,5-anhydroglucitol and clinical albuminuria were non-significant after adjustment. Subjects with low 1,5-anhydroglucitol (<10.0μg/ml) were more likely to experience diabetic retinopathy than those with high 1,5-anhydroglucitol (≥10.0μg/ml) under moderate glucose control (HbA_1c<8%, 64mmol/mol) and there were no significant differences in the prevalence of diabetic retinopathy between the subgroup with HbA_1c<8% (64mmol/mol) and low 1,5-anhydroglucitol and the subgroup with HbA_1c≥8% (64mmol/mol). Conclusions 1,5-Anhydroglucitol levels show close associations with diabetic retinopathy, especially among patients under moderate glucose control, but not with albuminuria. These results suggest that 1,5-anhydroglucitol might be a complementary marker for targeting higher risk group.