Fructosamine

Overview:

Evaluate diabetic control, reflecting diabetic control over a shorter time period (one to three weeks) than that represented by hemoglobin A1c (four to eight weeks). Indicated as an index of longer-term control than glucose levels, especially in diabetic subjects with abnormal hemoglobins and in type 1 diabetes in children.1

Fructosamine is found in the plasma of both normal and diabetic individuals. “Fructosamine” is the term used to describe proteins that have been glycated (ie, are derivatives of the nonenzymatic reaction product of glucose and albumin). It has been advocated as an alternative test to hemoglobin A1c for the monitoring of long-term diabetic control. Fructosamine and hemoglobin A1c do not measure exactly the same thing, since fructosamine has a shorter half-life and appears to be more sensitive to short-term variations in glucose levels; however, this is not necessarily a disadvantage. Fructosamine is clearly superior in patients with abnormal hemoglobins because of the interference of abnormal hemoglobins in the anion-exchange chromatography methods for Hb A1c. Published reference interval for apparently healthy subjects between age 20 and 60 is 205−285 μmol/L and in a poorly-controlled diabetic population is 228−563 μmol/L with a mean of 396 μmol/L.

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Croxson SC, Absalom S, Burden AC. Fructosamine in diabetes screening of the elderly. Ann Clin Biochem. 1991 May; 28(Pt 3):279-282. PubMed 1872575

Melzi d'Eril GV, Bosoni T, Solerte SB, Fioravanti M, Ferrari E. Performance and clinical significance of the new fructosamine assay in diabetic patients. Wien Klin Wochenschr Suppl. 1990; 180:60-63. PubMed 2321395

Narayanan S. Laboratory monitoring of gestational diabetes. Ann Clin Lab Sci. 1991 Nov-Dec; 21(6):392-401. PubMed 1781664