A comparison of fructosamine and HbA1c for home self-monitoring blood glucose levels in type 2 diabetes.

Abstract

BACKGROUND: Optimal glycemic control is believed to be essential in patients with diabetes to minimize any long-term complications. Measurement of the levels of glycated protein, such as fructosamine and glycated hemoglobin (HbA1c), is the most reliable method for assessing a period of glycemic control. This prospective study was performed to investigate whether fructosamine or HbA1c could provide a reliable index of glycemic control in type 2 diabetes. METHODS: Twenty-five patients with type 2 diabetes were studied at four-week intervals. Their fasting, preprandial and postprandial blood glucose levels were checked by glucometer twice a week for 16 weeks. Serum fructosamine and HbA1c were measured on every visit. The correlation of fructosamine and HbA1c with self-monitoring of blood glucose (SMBG) values in the previous 1 to 16 weeks prior to their measurements were calculated. RESULTS: Both fructosamine and HbA1c were significantly correlated with SMBG values from one week to 16 weeks prior to measurements. The correlation between fructosamine and SMBG was stronger in the prior 3 to 6 weeks. The correlation between HbA1c and SMBG was higher in the previous 4 to 12 weeks with the peak falling in the previous 8-10 weeks. Except for the previous one week, all the correlations were significantly stronger between HbA1c and SMBG than between fructosamine and SMBG. CONCLUSIONS: In type 2 diabetes, serum fructosamine assay can better reflect average blood glucose concentration over the previous 3 to 6 weeks and HbA1c is better reflective over the previous 8 to 10 weeks. HbA1c measurement correlates more significantly with home capillary blood glucose levels than the fructosamine assay, even over the previous 2 to 3 weeks.