Two New Lab Values May Predict Diabetes

Could fructosamine and glycated albumin testing soon be as common as A1C?… 

Testing a patient’s fructosamine and glycated albumin levels could be beneficial in some circumstances. For both of these markers, a level greater than the 95^th percentile has been correlated to an increased risk for diabetes as well as having an increased risk of microvascular complications such as retinopathy and kidney disease.

The diabetes association of being above the 95^th percentile for both markers is moderately accurate, however, neither of these new markers has a greater association than the A1C. For diabetes prediction, A1C was found to be better than fructosamine as well as glycated albumin with a C-statistic of 0.759 versus respective values of 0.706 and 0.703. Because of this, the potential place for these new levels may be as adjunctive values to the A1C or in situations where it would be difficult to get an accurate A1C.

The fructosamine test is currently available in the United States, but is not used very often yet due to the lack of long term studies regarding outcomes in the long-term. The test for glycated hemoglobin is not currently available in the United States, but is currently being used in Japan.

More information regarding these levels will need to be obtained before they are as highly regarded as the standard A1C levels, including which populations of people would benefit the most. However, these tests could become important adjunctive diagnostic tools for patients at risk for diabetes or microvascular damage.

• Fructosamine and glycated albumin levels may soon be measured in order to assess a patient’s diabetes risk.
• A level greater than the 95^th percentile has been correlated with a risk for diabetes for both fructosamine as well as glycated albumin.
• Fructosamine and glycated albumin levels are not as predictive for diabetes as A1C levels, but they have a strong association with risk for microvascular damage.

The Lancet Diabetes and Endocrinology, January 2014