Aim: Recent data have suggested that effective control of postprandial blood glucose can reduce the risk of macroangiopathic complications of diabetes, especially cardiovascular risk. 1,5-Anhydro-D-glucitol (1,5-AG) has been proposed as a marker of short-term hyperglycaemic excursions. We aimed to evaluate its usefulness in patients with type 2 diabetes and have attempted to indicate when 1,5-AG monitoring should be used in ordinary diabetes care settings. Methods: The study group consisted of 130 type 2 diabetic patients aged 3669 years. 1,5-AG plasma level, HbA1c concentrations and daily glucose profile were measured. Mean blood glucose (MBG), M-value were calculated and maximal daily glycaemia (MxG) was established as indicators of short-term hyperglycaemic episodes. Results: 1,5-AG plasma level was negatively and HbA1c was positively correlated with fasting glycaemia (FG), MBG, M-value and MxG. Multivariate regression analysis revealed that 1,5-AG plasma level is determined by MxG only, while FG determined HbA1c concentration in blood. The analysis of 1,5-AG level and HbA1c distributions in well and poorly controlled patients revealed that persons with low HbA1c values may have decreased 1,5-AG plasma level. Conclusion: 1,5-AG plasma level monitoring is the useful method to identify well controlled, exclusively based on HbA1c levels type 2 diabetic patients with transient hyperglycaemia, accordingly patients at high risk of macroangiopathic complications.

Background T cells are among the earliest cells to infiltrate the arterial intima during the initial stages of atherosclerosis. Alterations in the peripheral blood lymphocyte distribution might be associated with intensive lymphocytes extravasation and stimulation of atherosclerotic plaque development. Epidemiological data reveal that short-term postprandial hyperglycemia is a significant risk factor for coronary heart disease. Using a parameter that indicates recently-past acute hyperglycemia, 1,5-anhydro-D-glucitol (1,5-AG), the aim of the present study was to elucidate which alterations in peripheral blood T-lymphocytes, if any, are associated with acute hyperglycemia in patients with type 2 diabetes mellitus (DM) and, thus, might be involved in the progression of atherosclerosis. Methods and Results Measurement of fasting glucose level, glycated hemoglobin A1c, 1,5-AG, lipid profile and lymphocyte receptors expression (CD3+, CD4+, CD8+, CD8+28+, CD+28 -) was performed in 97 patients with type 2 DM, 23 patients with coronary heart disease, and 15 healthy controls. The mean CD3+, CD4+, CD8+28 - and CD8+28+ lymphocyte counts were significantly higher in the DM patients than in both control groups. Multiple regression analysis revealed that CD4+ and CD8+28- lymphocyte counts primarily were dependent on 1,5-anhydro-D-glucitol plasma levels. Conclusions These results suggest that acute hyperglycemia results in the progression of atherosclerosis in type 2 DM, at least in part through changes in CD4+ and CD8+28- lymphocyte subsets. (Circ J 2007; 71: 962 - 967)