Abstract
Glycated albumin (GA) is a marker of glycemic control that reflects postprandial plasma glucose levels and glycemic excursions better than HbA1c. However, no reports have examined correlations between diabetes duration and the ratio of glycated albumin to HbA1c (GA/HbA1c ratio) in patients with autoimmune type 1 diabetes (T1AD) or type 2 diabetes (T2D). We conducted a cross-sectional study involving 219 patients with T1AD and 141 patients with T2D. We evaluated correlations between diabetes duration, the GA/HbA1c ratio and fasting serum C-peptide immunoreactivity (CPR), index of insulin secretion capacity. The GA/HbA1c ratio was significantly correlated with diabetes duration in both T1AD and T2D patients (T1AD; R=0.139, p<0.001, T2D; R=0.340, p<0.001). Fasting serum CPR was inversely correlated with diabetes duration (T1AD: R=-0.280, p<0.001; T2D: R=-0.349, p<0.001) as well as the GA/HbA1c ratio (T1AD: R=-0.240, p<0.001; T2D: R=-0.378, p<0.001) in both T1AD and T2D patients. We firstly reported that the GA/HbA1c ratio was positively correlated with diabetes duration in both T1AD and T2D patients. Insulin secretion capacity might influence this relationship.
Highlights
Insulin secretion in pancreatic β cells progressively decreases with longer disease duration in both autoimmune type 1 diabetes (T1AD) and type 2 diabetes (T2D) [1,2] Cardiovascular disease and microvascular complications increase with longer diabetes duration [3] and decrease quality of life
In terms of glycemic control markers, HbA1c did not differ significantly between the groups (T1AD: 7.5 ± 1.0%, T2D: 7.6 ± 0.9%, p=0.415), but glycated albumin (GA) was significantly higher in the Autoimmune Type 1 Diabetes (T1AD) patients than the T2D patients (T1AD: 23.3 ± 4.5%, T2D: 20.7 ± 3.4%, p
We found that the GA/ HbA1c ratio was significantly positively correlated with diabetes duration in both T1AD and T2D patients (Figure 1)
Summary
Insulin secretion in pancreatic β cells progressively decreases with longer disease duration in both autoimmune type 1 diabetes (T1AD) and type 2 diabetes (T2D) [1,2] Cardiovascular disease and microvascular complications increase with longer diabetes duration [3] and decrease quality of life. An association between glycemic excursions with the onset and progression of cardiovascular disease and microvascular complications has recently been reported [4,5,6]. HbA1c is currently used as the main determinant of glycemic control in diabetes treatment [7]. HbA1c primarily reflects mean blood glucose levels over time and does not reflect glycemic excursions. On the other hand, glycated albumin (GA), another glycemic control indicator, correlates with maximum blood glucose levels in both T1AD and T2D and reflects glycemic excursions as well as mean blood glucose [8,9]. Recent interest has focused on the usefulness of the GA/HbA1c ratio (corrected for HbA1c) in diabetes treatment as a marker to reflect glycemic excursions [8,10,11,12]
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