A proposed glycemic control marker for the future: glycated albumin

Abstract

The goal of treatment of diabetes is to prevent the onset and the progression of chronic diabetic complications. Since the mechanism of the onset of the chronic complications is still not well understood, the main strategy is to bring the patient’s glycemic control status as close as possible to that of healthy subjects and to keep good glycemic control over the long term. Glycated protein can be used as a glycemic control indicator, and currently, HbA1c is used as the gold standard. HbA1c reflects the average glycemic value over approximately three months. However, HbA1c is affected by red blood cell (RBC) turnover, and HbA1c does not provide a measure of plasma glucose fluctuation or hypoglycemia. Glycated albumin (GA) assay is albumin specific measurement different form fructosamine, which can change due to a fluctuation of other serum proteins concentrations. GA reflects the glycemic control status for about the previous two to three weeks because of the half-life of albumin. GA is likely to reflect the plasma glucose fluctuation, whereas GA is also influenced by albumin metabolism including obesity. Here, we focused on GA as a biomarker for hyperglycemia.