# Enhancing Postprandial Hyperglycemia Detection Sensitivity in Individuals With Impaired Glucose Tolerance by Incorporating 1,5-Anhydroglucitol Into Diagnostic Testing: A Multicenter and Prospective Observational Study

## TL;DR

This study investigates whether adding 1,5-anhydroglucitol to standard tests improves detection of high blood sugar after meals in people with early glucose issues.

## Contribution

The study shows that combining 1,5-AG with existing tests improves sensitivity for detecting postprandial hyperglycemia in individuals with impaired glucose tolerance.

## Key findings

- 1,5-AG alone was not more sensitive than HbA1c for detecting glucose spikes.
- Combining 1,5-AG with FBG or HbA1c significantly improved detection sensitivity.
- 1,5-AG could enhance standard screening for postprandial hyperglycemia risk.

## Abstract

Objective: Prospective multicenter trials evaluating the sensitivity of 1,5-anhydroglucitol (1,5-AG) for detecting postprandial hyperglycemia in individuals with impaired glucose tolerance during health checkups in regional Japanese cities are limited. This study aims to address this gap through a comprehensive investigation.

Methods: Sixty-two participants with glycated hemoglobin (HbA1c) levels of 5.6-6.5% underwent a 75 g oral glucose tolerance test. Our primary objective was to evaluate the sensitivity of 1,5-AG compared to HbA1c in detecting ≥180 mg/dL glucose levels after an hour. Secondary endpoints are the sensitivity and specificity of the detection of load hyperglycemia.

Results: The area-under-the-curve analysis indicated that 1,5-AG was not more sensitive than HbA1c in detecting ≥180 mg/dL glucose levels (0.543 vs. 0.686, p = 0.236). However, combining 1,5-AG with fasting blood glucose (FBG: 27.8% vs. FBG + 1,5-AG: 72.2%, p = 0.004) or HbA1c (HbA1c: 44.4% vs. HbA1c + 1,5-AG: 72.2%, p = 0.042) improved the sensitivity of detecting glucose spikes, suggesting that 1,5-AG may be a valuable addition to standard screening protocols for reducing undetected postprandial hyperglycemia, a risk factor for diabetes and cardiovascular diseases.

Conclusion: These findings support the potential of 1,5-AG as an early marker of postprandial hyperglycemia during routine health checks.