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

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.