Measurement of serum 1,5-AG provides insights for diabetes management and the anti-viral immune response

Marcus Tong Zhen Wei; Linda A Gallo; Katina D Hulme; Fawaz Alzaid; Jean-Baptiste Julla; Emily S Dorey; Gilles Morineau; Keng Yih Chew; Emma J Grant; Stephanie Gras; Helen L Barett; Jean-Pierre Riveline; Meagan Carney; Kirsty R Short

doi:10.1007/s00018-024-05568-7

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Measurement of serum 1,5-AG provides insights for diabetes management and the anti-viral immune response

Journal article

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Measurement of serum 1,5-AG provides insights for diabetes management and the anti-viral immune response

Marcus Tong Zhen Wei, Linda A Gallo, Katina D Hulme, Fawaz Alzaid, Jean-Baptiste Julla, Emily S Dorey, Gilles Morineau, Keng Yih Chew, Emma J Grant, Stephanie Gras, …

Cellular and Molecular Life Sciences, Vol.82, pp.1-10

2025

DOI: https://doi.org/10.1007/s00018-024-05568-7

PMCID: PMC11803061

PMID: 39912911

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Abstract

glycaemic variability

1-5-AG

HbA1c

immune response

Background Achieving an in-range glycated haemoglobin (HbA1c) is essential for managing diabetes mellitus (DM). However, this parameter provides an estimate of long-term blood glucose control rather than daily glycaemic variations. Glycaemic variability can be more predictive than HbA1c in terms of identifying those at risk for diabetes complications, including risk of severe respiratory virus infections and is usually measured via a continuous glucose monitor (CGM). For individuals for whom a CGM is not available, serum 1,5 anhydroglucitol (1,5-AG) level has shown potential as an alternative method for monitoring glycaemic variability. Despite this, at present 1,5-AG is not routinely used in the clinical assessment of DM. Here, we aim to determine whether assessing 1,5-AG, in addition to HbA1c, is of any potential clinical utility to the management of DM for patients. Methods Using machine learning and data derived from 78 patients with type I DM (for whom CGM data is available) we show that the combination of 1,5-AG and HbA1c improves the prediction of a patient’s glycemia risk index (GRI) compared to HbA1c alone. Results The GRI is an essential tool in the management of DM as it reflects both clinical priorities and patient centred outcomes. The inclusion of 1,5-AG in this prediction was particularly important for individuals who had very high or very low GRI. Furthermore, in the context of glycaemic variability and susceptibility to severe respiratory virus infections, we show that reduced 1,5-AG in the plasma is associated with reduced ex vivo CD4 + T cell cytokine responses to influenza virus in individuals with a matched HbA1c. Conclusions Taken together, these data argue for an increased monitoring of 1,5-AG in the clinic for individuals without a CGM to provide additional insights for diabetes management.

Details

Title: Measurement of serum 1,5-AG provides insights for diabetes management and the anti-viral immune response
Authors: Marcus Tong Zhen Wei - The University of Queensland
Linda A Gallo - University of the Sunshine Coast, Queensland, School of Health - Biomedicine
Katina D Hulme - The University of Queensland
Fawaz Alzaid - Université Paris Cité
Jean-Baptiste Julla - Université Paris Cité
Emily S Dorey - Mater Research
Gilles Morineau - Université Paris Cité
Keng Yih Chew - The University of Queensland
Emma J Grant - La Trobe University
Stephanie Gras - La Trobe University
Helen L Barett - Mater Research
Jean-Pierre Riveline - Université Paris Cité
Meagan Carney - The University of Queensland
Kirsty R Short (Corresponding Author) - The University of Queensland
Publication details: Cellular and Molecular Life Sciences, Vol.82, pp.1-10
Publisher: Birkhaeuser Science
Date published: 2025
DOI: 10.1007/s00018-024-05568-7
ISSN: 1420-9071
PMID: 39912911; PMC11803061
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: All data and materials are available from the corresponding upon request.
Grants: The role of glycaemic variability in influenza virus pathogenesis and immunity, 1159959, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Pandemic-proofing our future, 2007919, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Grant note: Revadiab was funded by the Clinical Research Center (CRC) of APHP (Assistance Publique - Hôpitaux de Paris) and supported by a grant from the French Society of Diabetes (SFD). The 1.5 AG assay was funded by ANR-19-CE14-0005 MitoFLAME.
Organisation Unit: School of Health - Biomedicine
Language: English
Record Identifier: 991127205902621
Output Type: Journal article

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