Use GlycoMark to reduce the risk of diabetes complications.

Hemoglobin A1c (HbA1c) values between 6.5 and 8.5% can be misleading. Up to half of the patients in this range may not be in “near normal glycemic control” and may still be at significant risk of complications of diabetes. GlycoMark® is uniquely positioned to differentiate these patients from those who actually are in good control.

The Diabetes Control and Complications Trial (DCCT) and The United Kingdom Prospective Diabetes Study (UKPDS) both show that lowering hemoglobin A1c from 8.5 to below 6.5% significantly reduces the risk of complications from diabetes. The UKPDS showed that each 1% reduction in HbA1c was associated with a 14% reduction in risk of MIs. Risk reductions were also noted in the DCCT with cardiovascular (41%), neuropathy (60%), retinopathy (63%), nephropathy (54%), decreasing when HbA1c drops from 9 to 7.2%. Unfortunately, less than half of diabetic patients were able to achieve the targeted goal of an HbA1c less than 7.0% and fewer than 30% of those who reached this goal were able to maintain it over time (Dungan, Kathleen M. 2008. 1,5-anhydroglucitol (GlycoMarktm) as a marker of short-term glycemic control and glycemic excursions. Expert Rev. Mol. Diagn. 8(1): 9-19.

Most patients have been successful in lowering HbA1c to below 8.5% by diet and therapy; however, achieving levels below 6.5% is quite challenging. GlycoMark can provide a clear picture of actual glycemic control not provided by either hemoglobin A1c or fructosamine thereby allowing you to effectively manage your patient through modifications of diet and/or therapy.

GlycoMark is unique among diabetes diagnostic markers.

GlycoMark uniquely reflects all postprandial hyperglycemia above the renal threshold (>180 mg/dL serum glucose) over the prior one to two weeks.
Most hyperglycemia occurring at HbA1c less than 8.5% is postprandial glucose.
Hemoglobin A1c (HbA1c) and fructosamine (FA) average mean fasting glucose over 2 – 3 months and 2 – 3 weeks, respectively These can produce misleading information regarding actual glycemic control.
GlycoMark is the trade name for a FDA approved blood test for 1,5-anhydroglucitol (1,5-AG), a close analog of glucose.
The normal serum 1,5-AG range in adults and children is 10 to 30 µg/ml.
The diagnostic range is from <2 to 10 µg/ml.
Pharmaceutical companies use GlycoMark to monitor the effects of postprandial anti-hyperglycemic therapy.
Several clinical studies are underway to assess GlycoMark as a screening test for diabetes and as a marker for cardio-vascular disease.
Major diagnostic laboratories provide GlycoMark has a premier test for 2008.
GlycoMark is a straightforward and stable assay and is adaptable to any automated open chemistry analyzer.
GlycoMark is reimbursed by Medicare and private insurers.

Assay requirements and limitations

GlycoMark is contraindicated in patients with kidney disease (creatinine >1.5).
GlycoMark is to be used with serum or EDTA plasma. This assay may work with other anticoagulants but these are not recommended.
GlycoMark diagnostic values may vary in pregnant women and the elderly due to changes in the renal threshold
Persistently positive urinary glucose levels, or oxyhyperglycemia after gastrectomy, may result in a low 1,5AG value.
Low values have also been observed in pregnancy, terminal stage renal failure, dialysis patients, advanced cirrhosis, and prolonged incapability of oral ingestion of food.
Abnormal values have also been noted in individuals with damaged proximal renal tubules (assessed by urinary αGlutathione S-transferase).
For some patients with severe hyperglycemia, the internal pool of 1,5AG may remain depleted as a result of persistent glucosurea. In these cases, measurements of 1,5AG may be less indicative of initial recovery following initiation of anti-diabetic treatment.
1,5AG values may be increased when some Chinese medicines, such as Polygala, Tenuifolia and Senega syrup, are administered.
Values may also be increased during intravenous hyperalimentation. 1,5AG values may be lower in patients undergoing therapy with steroids.
As with all diagnostic tests, GlycoMark™ results should be interpreted along with clinical findings and results from other diagnostic methods.


A New Look At PPG	GlycoMark Presentation* [1.2MB PowerPoint] *Please allow a few minutes for this presentation to open.