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Aims: This study aimed to explore the level of and changes in the 1,5-anhydroglucitol × glycated hemoglobin A1c/100 (AH index, AHI) associated with different glucose metabolism statuses and to evaluate the islet function and insulin sensitivity of patients with type 2 diabetes (T2DM) with different AHI levels. Methods: Of the 3562 subjects enrolled in this study, 1697 had T2DM. The disposition index (DI) was the product of islet secretion function and insulin sensitivity-related indexes. Results: The mean AHI level was 1.0 (0.7–1.3) in the general population, while the mean AHI level in the T2DM group was 0.8 (0.5–1.2), which was significantly lower than that in the impaired glucose regulation and normal glucose tolerance group (both 1.2 (0.9–1.5), both P < 0.01). We further divided patients with T2DM into four subgroups according to the quartile of AHI. The results showed that with the increase in AHI level, the homeostasis model assessment of insulin resistance (HOMA-IR) decreased, while HOMA-β, insulin generation index, insulin sensitivity index, and DI increased (all Pfor trend < 0.01). Multivariate logistic regression showed that the odds ratios for a low DI for increasing levels of AHI were 1.00, 0.22 (0.16–0.29), 0.16 (0.11–0.22), and 0.09 (0.06–0.13), showing a decreasing trend (Pfor trend < 0.05). Conclusion: The AHI could reflect the variation in glycemic disorder and the function of islet β cells. The lower the AHI, the worse the glycemic disorder, as well as the islet β-cell function. [ABSTRACT FROM AUTHOR]