Dr. Shanik Case Study


Submitting Physician:
Dr. Michael H. Shanik, M.D., F.A.C.P., F.A.C.E.
Endocrine Associates of Long Island
Smithtown, NY

 

 

Patient Case:

A 47 year old male with Type 2 diabetes. A1C levels were relatively stable, ranging from 6.0 to 6.8% over a 12-month period.

Current Treatment: Stable doses of metformin monotherapy.

Lab work: A1C, 6.8%

Based on “moderate” glycemic control, ordered GlyoMark test (1,5-Anhydroglucitol, or 1,5-AG) to evaluate glycemic control for the prior two weeks.

Lab work: GlycoMark test, 8.6 µg/mL.

GlycoMark Reference Range:1

Result Interpretation
10 – 31 µg/mL* GlycoMark Normal
< 10 µg/mL* GlycoMark Abnormal

Interpretation: Low GlycoMark was indicative of elevated postprandial glucose levels.

Treatment: Exenatide 5 mcg twice daily for one month was initiated, followed by exenatide 10 mcg twice daily.

After three (3) months, retested A1C and GlycoMark.

Lab work: A1C,6.5% (4% change)
GlycoMark test, 12.5 µg/mL (45% change)

Interpretation: GlycoMark improvement suggested recent improvement in blood sugars, with a greater percent change in value compared to A1C.

Analysis:

By evaluating glycemic control in a patient with Type 2 diabetes with the GlycoMark test, recent postprandial glucose levels were detected.  With exenatide, glycemic control improved, as shown by the 45% improvement in the GlycoMark test result, as compared to the improved glycemic control demonstrated by a 4% improvement in the A1C.