Serum 1,5-Anhydroglucitol to Glycated Albumin Ratio Can Help Early Distinguish Fulminant Type 1 Diabetes Mellitus from Newly Onset Type 1A Diabetes Mellitus.

Abstract

BACKGROUND:

Fulminant type 1 diabetes mellitus (FT1DM) onsets abruptly and usually occurs within 1 week after the onset of hyperglycemic symptoms. Glycated albumin (GA) and 1,5-anhydroglucitol (1,5-AG) are indicators that reflect short-term glucose levels. This study was aimed at investigating whether the 1,5-AG/GA index (AGI) is a suitable indicator for early FT1DM identification.

METHODS:

A total of 226 subjects were enrolled, all with glycated hemoglobin A1c (HbA1c) < 8.7%. FT1DM was diagnosed based on the 2012 Japan Diabetes Society criteria.

RESULTS:

The AGI level was 0.54 (0.17-1.36) in the whole group. It was lower in FT1DM patients (0.16 [0.10-0.25]). Among the participants whose HbA1c did not exceed 7.0%, the AGI of FT1DM decreased significantly compared to type 1A diabetes (T1ADM) and latent autoimmune diabetes in adults (LADA) patients (0.16 [0.12-0.26] vs. 0.46 [0.24-0.72] vs. 0.46 [0.24-0.72] P < 0.05). The receiver operating characteristic (ROC) curve showed that AGI can be used to distinguish FT1DM and T1ADM patients with HbA1c < 8.7%. Diagnosing FT1DM based on AGI ≤ 0.3 only can help narrow down suspected FT1DM by up to 26.87%. If we diagnosed FT1DM when AGI was ≤0.3 and HbA1c was ≤7.0%, the success rate further increased to 86.57%, among which 85.00% of FT1DM and 87.23% of T1ADM patients were successfully identified. Therefore, using the combination criteria of AGI and HbA1c would improve the differential diagnosis efficacy by 61.11% compared with the AGI criterion only.

CONCLUSION:

AGI can help facilitate the early differential diagnosis of FT1DM and T1ADM when HbA1c < 8.7%, with an optimal cut-off point of 0.3.

• Authors: Lingwen Ying, Xiaojing Ma, Yun Shen, Jingyi Lu, Wei Lu, Wei Zhu, Yufei Wang, Yuqian Bao, Jian Zhou
• Journal: Journal of diabetes research (J Diabetes Res) Vol. 2020 Pg. 1243630 ( 2020) ISSN: 2314-6753 [Electronic] England
• PMID: 32280712 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Lingwen Ying et al.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Glycation End Products, Advanced
• Serum Albumin
• 1,5-anhydroglucitol
• Deoxyglucose
• Glycated Serum Albumin

Topics

• Adult
• Blood Glucose (analysis)
• Deoxyglucose (blood)
• Diabetes Mellitus, Type 1 (blood, diagnosis)
• Diagnosis, Differential
• Female
• Glycated Hemoglobin (analysis)
• Glycation End Products, Advanced
• Humans
• Male
• Middle Aged
• Serum Albumin (analysis)
• Glycated Serum Albumin