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Study on polyol metabolism in children with insulin dependent diabetes mellitus: Clinical significance of plasma 1,5-anhydroglucitol levels in children with insulin dependent diabetes mellitus



Study on polyol metabolism in children with insulin dependent diabetes mellitus: Clinical significance of plasma 1,5-anhydroglucitol levels in children with insulin dependent diabetes mellitus



Medical Journal of Hiroshima University 46(3-4): 99-106



Recently plasma 1,5-anhydroglucitol (AG) level has been reported to be useful for diabetes screening and glycemic control in non-insulin dependent diabetes mellitus. However, its clinical significance has not been fully evaluated in children with insulin dependent diabetes mellitus (IDDM). The plasma levels of AG and HbA1c were measured in 28 IDDM outpatients (12 boys, 16 girls, 15.9 +- 6.6 years). The plasma AG concentration (pAG) was determined by gas chromatography. pAG in IDDM patients (2.0 +- 4.1 mug/ml) was significantly lower (p<0.01) than in healthy subjects (23.5 +- 6.5 mug/ml). The pAG was significantly higher (p<0.01) in 5 newly diagnosed diabetic patients than in diabetic patients with over 3 years' duration. The recovery of pAG by over 10 mug/ml was recognized after starting insulin treatment in 3 newly diagnosed diabetic patients. On the other hand, it remained under 5.0 mug/ml (most of them, 3.0 mug/ml) in IDDM with over 3 years' duration. pAG was significantly different among the patients with over 3 years. duration with similar HbA1c levels. These observation suggest that it is difficult to use as a clinical marker for glycemic control in long standing IDDM. Although further studies are needed to clarify whether augmentation of glucose oscillation, in long standing IDDM patients with fair glycemic control, may give rise to the discrepancy between AG and HbA1c.

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