# Effects of Balanced Dietary Patterns and/or Integrated Exercise on Serum 1,5-Anhydroglucitol and CVD Risk Factors in Individuals with Prediabetes

## TL;DR

This study identifies 1,5-anhydroglucitol as a key biomarker for diabetes progression and shows that lifestyle changes can improve blood sugar levels in prediabetic individuals.

## Contribution

The study introduces 1,5-anhydroglucitol as a sensitive biomarker for dysglycemia that responds to lifestyle interventions.

## Key findings

- 1,5-anhydroglucitol (1,5-AG) effectively differentiates prediabetic from diabetic individuals with high accuracy.
- A combined diet and exercise intervention improved blood glucose markers and increased serum 1,5-AG levels in prediabetic individuals.
- The intervention showed a trend toward reduced diabetes incidence but had limited impact on cardiovascular risk factors like BMI and blood pressure.

## Abstract

This study aimed to identify metabolomic biomarkers for diabetes progression and validate their response to lifestyle intervention. A two-phase design was employed: first, untargeted metabolomics distinguished normoglycemic, prediabetic (PDM), and diabetic (DM) individuals, identifying 1,5-anhydroglucitol (1,5-AG) as the most significant biomarker for differentiating PDM from DM (apparent AUC = 0.97, 95% CI: 0.95–1.00; corrected AUC = 0.94, 95% CI: 0.83–1.00; q < 0.001). Second, in a 3-month randomized controlled trial involving 300 adults with PDM, the combined diet and exercise intervention significantly improved fasting blood glucose and glycated hemoglobin levels, while concurrently elevating serum 1,5-AG levels compared with the control group, though it did not yield significant improvements in other cardiovascular disease-related risk factors including body mass index, waist circumference, systolic blood pressure, and diastolic blood pressure. The intervention also showed a trend toward reduced diabetes incidence. Integrated analysis establishes 1,5-AG as a sensitive biomarker of dysglycemia that is responsive to lifestyle modification, supporting its potential as a mechanistic tool for monitoring intervention efficacy in diabetes prevention.