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Purpose: The prevalence of type 2 diabetes mellitus (T2DM) and obesity are currently increasing. Accordingly, the concept of “preventing diabetes” in highrisk groups has become more important in diabetic care, but the use of glycated hemoglobin (HbA1c) as a measure has limitations in this field. The aim of this study was to investigate the utility of 1,5-anhydroglucitol (1,5-AG) in assessing prediabetes status in obese children. Methods: The medical records of 74 subjects aged 6–19 years (of which 27 were overweight/obese and 47 had diabetes) who had 1,5-AG data were reviewed retrospectively. We compared 1,5-AG with HbA1c using the Pearson correlation test to assess the clinical utility of 1,5-AG. Results: 1,5-AG levels were higher (31.1±10.1 μg/mL vs. 7.4±7.3 μg/mL) and HbA1c levels were lower (5.5%±0.3% vs. 8.9%±2.7%) in the overweight/obese group than in the diabetics group. The range of 1,5-AG levels in obese children was wide (16.8–59.3 μg/mL), and did not have significance with HbA1c. A negative correlation between 1,5-AG and HbA1c was significant in the entire subject (r=–0.822, P<0.001), and also in the HbA1c range of 5.5% to 8% (r=–0.736, P<0.001). Conclusion: 1,5-AG is a valuable index in the HbA1c range of 5.5%–8% and it might be considered an early glycemic control index in insulin-resistant obese children with an HbA1c level above 5.5%. Moreover, the 1,5-AG level assessment should be presented as a supplementary tool for better compliance, as well as being an improvement in diabetes management for the short-term glucose control in relatively well-controlled diabetes patients with an HbA1c level below 8%.

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