Abstract
We recently reported that glycated albumin (GA) is increased in subjects with longer duration of diabetes and with decreased insulin secretory function. Based on this, we investigated whether GA increases with time relative to glycated hemoglobin (HbA1c) and the association between GA and beta-cell function. We analyzed 340 type 2 diabetes patients whose serum GA and HbA1c levels had been repeatedly measured over 4 years. We assessed the pattern of changes with time in glycemic indices (GA, HbA1c, and GA/HbA1c ratio) and their relationship with beta-cell function. In all patients, glycemic indices decreased and maintained low levels around 15 and 27 months. However, from 39 months to 51 months, GA significantly increased but HbA1c tended to increase without statistical significance. We defined ΔGA/HbA1c as the difference between the nadir point (at 15 to 27 months) and the end point (at 39 to 51 months) and found that ΔGA/HbA1c was positively correlated with diabetes duration and negatively related to beta-cell function. In multivariable linear regression analyses, ΔGA/HbA1c was independently associated with diabetes duration. In conclusion, this study demonstrated that serum GA levels increase relative to HbA1c levels with time.
Highlights
Glucose monitoring is essential for the appropriate care and treatment of patients with diabetes in order to avoid diabetic complications and hypoglycemia
Glycated albumin (GA) has been gaining popularity as an indicator in several physiologic and pathologic conditions [5] because it provides more information than the gold standard HbA1c. In line with this trend, we have demonstrated the clinical relevance of GA in type 2 diabetes mellitus (T2D) with insulin secretory dysfunction rather than insulin resistance [6], fluctuating or poorly controlled glycemic excursions [7], and progressing atherosclerosis [8]
Evidence has accumulated on the clinical relevance of GA as a glycemic index
Summary
Glucose monitoring is essential for the appropriate care and treatment of patients with diabetes in order to avoid diabetic complications and hypoglycemia. The American Diabetes Association recommends glycated hemoglobin (HbA1c) testing in all diabetic patients as an initial assessment and as a part of continuing care [2]. Glycated albumin (GA) has been gaining popularity as an indicator in several physiologic and pathologic conditions [5] because it provides more information than the gold standard HbA1c In line with this trend, we have demonstrated the clinical relevance of GA in type 2 diabetes mellitus (T2D) with insulin secretory dysfunction rather than insulin resistance [6], fluctuating or poorly controlled glycemic excursions [7], and progressing atherosclerosis [8]. We investigated which clinical and biochemical parameters are associated with changes in the GA/HbA1c ratio
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