LAUSR

To the Editor: Glucose measured 2 h after a 75-g carbohydrate challenge is considered gold standard for diabetes diagnosis but is a burdensome test. 1,5-anhydroglucitol (1,5-AG) is a biomarker of glucose excursions that is of growing interest and is sometimes used in diabetes care. Blood concentrations of 1,5-AG are decreased when blood glucose exceeds the renal threshold (approximately 160–180 mg/dL); thus, low plasma 1,5-AG reflects recent (1–2 weeks) glucose excursions. Some preliminary reports have suggested that 1,5-AG may be useful as a screening test for diabetes (1, 2). We evaluated the diagnostic performance of 1,5-AG compared to 2-h and fasting glucose in a community-based population. We conducted a cross-sectional analysis of 7813 participants without diagnosed diabetes at the fourth study visit (1996–1998) of the Atherosclerosis Risk in Communities study. Plasma glucose was analyzed with an enzymatic method on the Roche Hitachi 911 machine. 1,5-AG (GlycoMark®) was measured in 2015–2016 in stored plasma samples (collected at the same study visit in 1996–1998) with the Beckman AU480 Chemistry Analyzer (interassay coefficient of variation, 4.54%). We examined the performance of low 1,5-AG (<10 μg/mL) to detect increased 2-h glucose (≥200 mg/dL), fasting glucose (≥126 mg/dL), or both. We calculated clinical …