Glycomark (1,5-anhydroglucitol) –indicates poor control of blood glucose spikes; specifically frequent hyperglycemic events over the past two weeks (not evidentfrom HbA1c). Postprandial hyperglycemia is associated with Cardiovascular disease and reduction of hyperglycemic events appear to decrease macro- and microvascular complications in diabetic patients. Low 1,5-AG is also associated with renal damage. Hemoglobin A1c (HbA1c) – estimates the average blood glucose concentration for the life of the red blood cell (120 days).
- Detects recent hyperglycemia and hyperglycemic excursions.
- Reveals improving or worsening glycemic control for the prior one to two weeks.
- Is independently associated with increased rates of diabetes complications.
- Identifies patients that may benefit from closer diabetes management. Is a non-fasting, FDA cleared blood test that complements A1C.
References:
Lee AK, Lee CJ, Huang ES, Sharrett AR, Coresh J, Selvin E. Risk Factors for Severe Hypoglycemia in Black and White Adults With Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Care. 2017 Dec;40(12):1661-1667. doi: 10.2337/dc17-0819. Epub 2017 Sep 19. PMID: 28928117; PMCID: PMC5711330.
Rawlings AM, Sharrett AR, Mosley TH, Ballew SH, Deal JA, Selvin E. Glucose Peaks and the Risk of Dementia and 20-Year Cognitive Decline. Diabetes Care. 2017 Jul;40(7):879-886. doi: 10.2337/dc16-2203. Epub 2017 May 12. PMID: 28500217; PMCID: PMC5481977.
Kim YG, Hahn S, Oh TJ, Kwak SH, Park KS, Cho YM. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Diabetologia. 2013 Apr;56(4):696-708. doi: 10.1007/s00125-012-2827-3. Epub 2013 Jan 24. PMID: 23344728.
Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care. 2003 Mar;26(3):881-5. doi: 10.2337/diacare.26.3.881. PMID: 12610053.
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ABNORMAL results indicate significant hyperglycemia and/or glycemic variability occurring in the fasting state, post-meal state, or both during the prior two weeks. ABNORMAL GlycoMark test results are independently associated with an increased risk of diabetes related complications.
- Consistent with significant recent hyperglycemia/glycemic variability.
- Consider fasting glucose, structured SMBG (Self-monitoring blood glucose) and/or CGM (Continuous Glucose Monitoring) to determine hyperglycemic patterns.
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Low levels of the GlycoMark (1,5-anhydroglucitol or 1,5-AG) marker are clinically significant as they provide an indication of short-term glycemic control in individuals with diabetes. GlycoMark is a relatively new biomarker that complements traditional measures like hemoglobin A1c (HbA1c) and fasting plasma glucose, offering insights into postprandial glucose excursions and overall glucose variability over the past one to two weeks.
1,5-AG is a glucose-like molecule present in food that is normally reabsorbed by the kidneys and maintained at stable levels in the blood. Under normal physiological conditions, 1,5-AG is almost entirely reabsorbed in the renal tubules. However, when blood glucose levels exceed the renal threshold (around 180 mg/dL), glucose spills into the urine and competes with 1,5-AG for reabsorption. This competition leads to increased urinary excretion of 1,5-AG and consequently lowers its plasma levels. Therefore, low levels of 1,5-AG are indicative of frequent or sustained hyperglycemia, especially postprandial hyperglycemia, where blood glucose levels spike significantly after meals.
The significance of low GlycoMark levels extends to the management and monitoring of diabetes. While HbA1c provides a picture of average glucose levels over the past two to three months, it does not capture daily glucose fluctuations. GlycoMark fills this gap by reflecting recent glycemic control, particularly identifying periods of hyperglycemia that may be masked by the averaging nature of HbA1c. For instance, a patient might have a "good" HbA1c level but still experience harmful post-meal spikes that GlycoMark can detect. This makes GlycoMark particularly valuable for patients with type 2 diabetes, who often struggle with postprandial glucose control, and for those whose HbA1c levels do not correlate well with their self-monitored blood glucose levels.
In clinical practice, GlycoMark can be used to tailor and optimize diabetes management strategies. For patients on insulin or other glucose-lowering therapies, monitoring GlycoMark can help in adjusting medication doses and timing to better control postprandial spikes. It also aids in dietary planning by providing feedback on the impact of specific foods on post-meal glucose levels. Additionally, GlycoMark can serve as a motivational tool for patients by offering more immediate feedback on the effectiveness of their glycemic control efforts compared to the longer-term feedback provided by HbA1c.
Moreover, research has shown that low GlycoMark levels are associated with an increased risk of diabetic complications, such as cardiovascular disease and retinopathy, which are exacerbated by frequent hyperglycemic episodes. Therefore, maintaining higher GlycoMark levels could potentially reduce the risk of these complications by ensuring more stable and controlled blood glucose levels.
In summary, low levels of the GlycoMark (1,5-AG) marker signify poor short-term glycemic control and frequent postprandial hyperglycemia. Its role in diabetes management is crucial, offering a more nuanced understanding of glucose control that goes beyond the scope of traditional markers like HbA1c. By highlighting periods of hyperglycemia and aiding in the fine-tuning of treatment regimens, GlycoMark helps in achieving better overall glycemic control and reducing the risk of diabetes-related complications.
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While we do talk about popular labs, we welcome reports from lots of other places too. It's as simple as this: if you can get a test done, you can upload it to Healthmatters. We can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
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%sdLDL-C, Apo B : Apo A-1, ApoA-I, Atherogenic index, Estimated CHD Risk, Fibrinogen, Glycomark (1 ,5-Anhydroglucitol), HDL % of Total Cholesterol, HDL-C, HDL-C/TG, hsCRP, IDL Cholesterol, LDL-C, LDL/HDL Cholesterol Ratio, Leptin : Adiponectin ratio, Myeloperoxidase (MPO), Non-HDL Cholesterol, Oxidized LDL, Oxidized LDL : LDL-C, OxLDL (Oxidized LDL), PLAC, PLAC (LP-PLA2 Activity), Small dense LDL Cholesterol, Small dense LDL-C : LDL-C, Total Cholesterol, Total Cholesterol/HDL Ratio, Triglycerides, Triglycerides to HDL Ratio, VLDL-C/TG, VLDL-C/TG (Boston Heart)