Background: Intermittent states of hyperglycemia have been identified as risk factor for vascular complications of type 2 diabetes mellitus independent from the mean blood glucose level. 1,5-Anhydroglucitol (1,5-AG) levels decrease when blood glucose is elevated above the renal threshold and has recently been proved as marker of intermittent, e.g. postprandial hyperglycemia. The objective of this cross-sectional study is to identify if 1,5 AG is related to the prevalence of vascular complications in patients with well-controlled type 2 diabetes mellitus. Methods: 164 patients with type 2 diabetes mellitus and hemoglobin A1c (HbA1c) ≤ 7 % under stable glycemic control were recruited between 2007 and 2010. Sera were analyzed for the 1,5-AG level using an enzymatic test (Glykomark™). Besides other relevant laboratory, biometric and demographic findings, the concomitant therapy and the prevalence of macrovascular (coronary heart disease, peripheral arterial disease, cerebrovascular disease) as well as microvascular (retinopathy, nephropathy) complications were recorded. After differentiation of the patients into cohorts with adequately and inadequately controlled diabetes mellitus according to 1,5-AG levels the prevalences of vascular complications and the used antidiabetic treatments in those groups were compared.

Results: There were no significant differences between patients with normal or reduced 1,5-AG levels regarding demographic and laboratory parameters as well as the kind of therapy. Prevalence of macro- and microvascular complications was 31.7% and 39%, respectively. There were no significant differences in the prevalence of macro- or microvascular complications between the subjects with normal and those with reduced 1,5-AG level. Also the surrogate parameters of cardiovascular complications (NT proBNP, homocysteine and vitamin D) did also not show any differences between both groups. 

Conclusion: In patients with well-controlled type 2 diabetes mellitus, no differences could be found concerning the prevalences of micro- and macrovascular complications between subjects with normal compared to reduced 1,5-AG levels.