Comparison of Glycated Albumin (GA) and Glycated Hemoglobin (HbA1c) in Type 2 Diabetic Patients: Usefulness of GA for Evaluation of Short-term Changes in Glycemic Control

Abstract

Abstract. We studied the cross-sectional relationship between GA and HbA1c in 142 type 2 diabetic patients who had an HbA1c level <7.5% for at least one year without fluctuation by more than 0.5%. We also followed the changes of GA and HbA1c in 18 type 2 diabetic patients for 16 weeks as they progressed from untreated severe hyperglycemia (HbA1c≥9.0%) to good glycemic control (HbA1c≤6.5%) by intensive insulin treatment. The annual mean levels of GA and HbA1c in the stably controlled patients showed a weak, but significant, correlation (r = 0.23, p<0.001) in the 142 diabetic patients. However, the GA/HbA1c ratio ranged widely from 2.0 to 4.0 showing a normal distribution (2.9 ± 0.34, M ± SE), although patients with conditions affecting albumin turnover or RBC lifespan were excluded from the study. The GA/HbA1c ratio was significantly higher when patients were in hyperglycemic than when glycemic control was good (3.5 ± 0.15 vs. 2.9 ± 0.07, M ± SE, p<0.01). GA decreased more rapidly than HbA1c during intensive insulin therapy, but the percent reduction of HbA1c eventually corresponded with that of GA by 16 weeks after the start of treatment. These results demonstrate that, although unknown influences on GA or HbA1c may exist, GA may be a useful marker for monitoring short-term variations of glycemic control during treatment of diabetic patients.

Association between glycemic control and birthweight with glycated albumin in Chinese women with gestational diabetes mellitus

“…The primary utility of the GA cut‐off level of 11.60% is to detect approximately 80% of subjects with poor glycemic control, to positively affect GDM management largely and to permit the early identification of subjects who are at imminent risk of disease development, and who can then be referred for further evaluation and appropriate management. In addition, GA use could be more sensitive to short‐term glycemic variations than HbA1c28, and also relegate SMBG testing. Thereby, increasing compliance and improving GDM women empowerment, which might result in significant healthcare cost savings.…”

Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus

“…GA better reflects short-term changes in plasma glucose than does HbA 1c [14,15]. In patients with fulminant type 1 diabetes, a subtype of type 1 diabetes in which the progression from normoglycaemia to hyperglycaemia accompanied by ketoacidosis is extremely rapid [29], HbA 1c levels at onset are normal or only slightly high [30].…”

“…Because the half-life of serum albumin is shorter than that of erythrocytes, GA reflects plasma glucose levels over a shorter period of time [14]. Thus, use of GA has been advocated for monitoring shortterm changes in glycaemic control [15]. In addition, because GA is not affected by haemoglobin metabolism, it is a useful indicator of glycaemic control in patients with haemolytic anaemia [16].…”

Proteomic study reveals downregulation of apolipoprotein A1 in plasma of poorly controlled diabetes: A pilot study

“…Development of these complications is 2.5 times higher in patients with long-term poorly controlled glycaemic levels than controlled levels (4). Furthermore, on the basis of glycated haemoglobin (HbA1c) levels diabetic subjects are categorized as having controlled diabetes (CD) and poorly controlled diabetes (PCD) with HbA1c levels ≤8% and >8%, respectively, of total haemoglobin (5). To understand the molecular mechanisms of pathophysiology of diabetic complications, numerous studies have utilized proteomic approaches, which have been reviewed in great detail (6).…”