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.
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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)
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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
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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
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