1,5-Anhydroglucitol in saliva is a noninvasive marker of short-term glycemic control

J Clin Endocrinol Metab. 2014 Mar;99(3):E479-83. doi: 10.1210/jc.2013-3596. Epub 2014 Jan 1.


Context: In most ethnicities at least a quarter of all cases with diabetes is assumed to be undiagnosed. Screening for diabetes using saliva has been suggested as an effective approach to identify affected individuals.

Objective: The objective of the study was to identify a noninvasive metabolic marker of type 2 diabetes in saliva.

Design and setting: In a case-control study of type 2 diabetes, we used a clinical metabolomics discovery study to screen for diabetes-relevant metabolic readouts in saliva, using blood and urine as a reference. With a combination of three metabolomics platforms based on nontargeted mass spectrometry, we examined 2178 metabolites in saliva, blood plasma, and urine samples from 188 subjects with type 2 diabetes and 181 controls of Arab and Asian ethnicities.

Results: We found a strong association of type 2 diabetes with 1,5-anhydroglucitol (1,5-AG) in saliva (P = 3.6 × 10(-13)). Levels of 1,5-AG in saliva highly correlated with 1,5-AG levels in blood and inversely correlated with blood glucose and glycosylated hemoglobin levels. These findings were robust across three different non-Caucasian ethnicities (Arabs, South Asians, and Filipinos), irrespective of body mass index, age, and gender.

Conclusions: Clinical studies have already established 1,5-AG in blood as a reliable marker of short-term glycemic control. Our study suggests that 1,5-AG in saliva can be used in national screening programs for undiagnosed diabetes, which are of particular interest for Middle Eastern countries with young populations and exceptionally high diabetes rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / analysis
  • Biomarkers / metabolism
  • Blood Glucose / metabolism*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Deoxyglucose / analysis
  • Deoxyglucose / metabolism*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Humans
  • Male
  • Mass Spectrometry / methods
  • Metabolomics / methods
  • Middle Aged
  • Saliva / chemistry
  • Saliva / metabolism*
  • Young Adult


  • Biomarkers
  • Blood Glucose
  • 1,5-anhydroglucitol
  • Deoxyglucose