Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA 1c reliability
Authors' conclusion
Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA1c in a population with high prevalence of conditions reported to affect HbA1c reliability.
Study context
- Population
- Africans living with T2D; high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment
- Comparison
- Glycated albumin (GA) and fructosamine vs HbA1c for assessing glycaemic control against mean continuous glucose monitoring (CGM) glucose
- Outcome
- Relationship of fructosamine, GA and HbA1c with mean CGM glucose
Performance
As reported in the abstract
Association with mean CGM glucose (r)
HbA1c
0.88
r · 95% CI 0.84–0.91
GA
0.84
r · CI 0.79–0.88
Fructosamine
0.84
r · CI 0.79–0.88
Further findings
Diagnostic accuracy for mean CGM glucose >8 mmol/L
- HbA1c similar diagnostic accuracy to GA and fructosamine, incl. in those with conditions reported to affect HbA1c (n = 63)
Effect of sickle cell trait (SCT) on relationship with CGM glucose
- No evidence SCT (n = 43/192) altered relationship of HbA1c, fructosamine or GA with CGM glucose
- P > 0.3 for all
Effect of anaemia on relationship with CGM glucose
- Anaemia: underestimation of CGM glucose by HbA1c and fructosamine vs no anaemia
- P for interaction < 0.005 for both
- Anaemia: GA relationship with CGM glucose not significantly different vs no anaemia
Original publication
Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA 1c reliability. Diabet Med. Published 27 April 2025. doi:10.
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