Top

Published in:

01-11-2014 | Diabetes Epidemiology (NM Maruthur, Section Editor)

Beyond HbA1c and Glucose: the Role of Nontraditional Glycemic Markers in Diabetes Diagnosis, Prognosis, and Management

Authors: Christina M. Parrinello, Elizabeth Selvin

Published in: Current Diabetes Reports | Issue 11/2014

Abstract

Fasting glucose and hemoglobin A1c (HbA1c) are the standard measures for diagnosis and monitoring of diabetes. There has been recent interest in nontraditional markers of hyperglycemia, including fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG), as alternatives or adjuncts to standard measures. There is a growing literature linking these nontraditional markers with microvascular and macrovascular complications. Fructosamine and glycated albumin have also been shown to improve identification of persons with diabetes. However, long-term prospective studies with clinical outcomes are lacking. Some modern laboratory assays for fructosamine, glycated albumin, and 1,5-AG have excellent performance. Expanded use of these tests has the potential to improve diabetes care as these measures may overcome limitations of HbA1c in certain patients, complement traditional measures by providing additional information on shorter-term glycemic control, and improve risk stratification for diabetes and its complications. Nonetheless, studies are needed to demonstrate if their routine use will benefit patients and improve outcomes.

Standards of medical care in diabetes–2014. Diabetes Care. 2014;37(Suppl 1):S14–80. doi:10.2337/dc14-S014.

International A, Committee E, Diabe- A, Federation ID, Committee IE, International T. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327–34.CrossRef

Rydén L, Grant PJ, Anker SD, et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the task force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration. Eur Heart J. 2013;34(39):3035–87. doi:10.1093/eurheartj/eht108.PubMedCrossRef

Consultation IDF. WHO IRIS: definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. 2006. Available at: http://apps.who.int/iris/handle/10665/43588. Accessed 29 Mar 2014.

World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. 2011;1–25.

International Diabetes Federation Clinical Guidelines Task Force. Global guideline for type 2 diabetes. 2012;1–52. doi:10.1016/j.diabres.2012.10.001.

7.•

Sacks DB. A1C versus glucose testing: a comparison. Diabetes Care. 2011;34(2):518–23. doi:10.2337/dc10-1546. This commentary discusses the current clinical utility of HbA1c, as well as its limitations. The author mentions fructosamine and glycated albumin as potential alternatives to HbA1c and , however, also notes the need for additional studies since there is a lack of data linking these markers to clinical outcomes from clinical trials and prospective studies, as well as no established clinical cut-points for use in persons with diabetes.PubMedCentralPubMedCrossRef

Inzucchi SE. Clinical practice. Diagnosis of diabetes. N Engl J Med. 2012;367(6):542–50. doi:10.1056/NEJMcp1103643.PubMedCrossRef

Sacks DB. Hemoglobin A1c in diabetes: panacea or pointless? Diabetes. 2013;62(1):41–3. doi:10.2337/db12-1485.PubMedCentralPubMedCrossRef

10.

True MW. Circulating biomarkers of glycemia in diabetes management and implications for personalized medicine. J Diabetes Sci Technol. 2009;3(4):743–7. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2769973&tool=pmcentrez&rendertype=abstract.PubMedCentralPubMedCrossRef

11.

Johns Hopkins POC-IT Guides: alternative markers of glycemia: fructosamine, glycated albumin, 1,5-AG. Available at: http://www.hopkinsguides.com/hopkins/ub/view/Johns_Hopkins_Diabetes_Guide/547055/all/Alternative_markers_of_glycemia:_fructosamine__glycated_albumin__1_5_AG. Accessed 20 June 2014.

12.

Joslin Diabetes Center: Home blood glucose (sugar) monitoring, hemoglobin A1C testing, and fructosamine tests. Available at: http://www.joslin.org/info/home_blood_glucose_sugar_monitoring_hemoglobin_a1c_testing_and_fructosamine_tests.html. Accessed 20 June 2014.

13.

Goldstein DE, Little RR, Lorenz RA, et al. Tests of glycemia in diabetes. Diabetes Care. 2004;27(7):1761–73. doi:10.2337/diacare.27.7.1761.PubMedCrossRef

14.

Selvin E, Crainiceanu CM, Brancati FL, Coresh J. Short-term variability in measures of glycemia and implications for the classification of diabetes. Arch Intern Med. 2007;167(14):1545–51. doi:10.1001/archinte.167.14.1545.PubMedCrossRef

15.

Meigs JB, Nathan DM, Cupples LA, Wilson PWF, Singer DE. Tracking of glycated hemoglobin in the original cohort of the Framingham Heart Study. J Clin Epidemiol. 1996;49(4):411–7. doi:10.1016/0895-4356(95)00513-7.PubMedCrossRef

16.

Little RR, Rohlfing CL. The long and winding road to optimal HbA1c measurement. Clin Chim Acta. 2013;418:63–71. doi:10.1016/j.cca.2012.12.026.PubMedCrossRef

17.

Little RR, Rohlfing CL, Sacks DB. Status of hemoglobin A1c measurement and goals for improvement: from chaos to order for improving diabetes care. Clin Chem. 2011;57(2):205–14. doi:10.1373/clinchem.2010.148841.PubMedCrossRef

18.

Rohlfing CL, Parvin CA, Sacks DB, Little RR. Comparing analytic performance criteria: evaluation of HbA1c certification criteria as an example. Clin Chim Acta. 2014;433:259–63.PubMedCrossRef

19.

Sacks DB, John WG. Interpretation of hemoglobin a1c values. JAMA. 2014;311(22):2271–2. doi:10.1001/jama.2014.6342.PubMedCrossRef

20.

Armbruster DA. Fructosamine: structure, analysis, and clinical usefulness. Clin Chem. 1987;33(12):2153–63. Available at: http://www.ncbi.nlm.nih.gov/pubmed/3319287. Accessed 5 Apr 2014.PubMed

21.

Buse JB, Freeman JLR, Edelman SV, Jovanovic L, McGill JB. Serum 1,5-anhydroglucitol (GlycoMark): a short-term glycemic marker. Diabetes Technol Ther. 2003;5(3):355–63. doi:10.1089/152091503765691839.PubMedCrossRef

22.

Dungan KM. (GlycoMark ™) as a marker of short-term glycemic control and glycemic excursions. 2008;9–19.

23.

Kim WJ, Park C-Y. 1,5-Anhydroglucitol in diabetes mellitus. Endocrine. 2013;43(1):33–40. doi:10.1007/s12020-012-9760-6.PubMedCrossRef

24.

Yamanouchi T, Akanuma Y. Serum 1,5-anhydroglucitol (1,5 AG): new clinical marker for glycemic control. Diabetes Res Clin Pract. 1994;24(Suppl):S261–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/7859616. Accessed 25 Jul 2014. PubMedCrossRef

25.

Yamanouchi T. Clinical usefulness of glycaemic control. Lancet. 1994;347:1514–8.CrossRef

26.

Ai M, Otokozawa S, Schaefer EJ, et al. Glycated albumin and direct low density lipoprotein cholesterol levels in type 2 diabetes mellitus. Clin Chim Acta. 2009;406(1–2):71–4. doi:10.1016/j.cca.2009.05.015.PubMedCentralPubMedCrossRef

27.

Juraschek SP, Steffes MW, Selvin E. Associations of alternative markers of glycemia with hemoglobin A(1c) and fasting glucose. Clin Chem. 2012;58(12):1648–55. doi:10.1373/clinchem.2012.188367.PubMedCentralPubMedCrossRef

28.••

Nathan DM, McGee P, Steffes MW, Lachin JM. Relationship of glycated albumin to blood glucose and HbA1c values and to retinopathy, nephropathy, and cardiovascular outcomes in the DCCT/EDIC study. Diabetes. 2014;63(1):282–90. doi:10.2337/db13-0782. This was an important study conducted in a subsample of participants from the Diabetes Control and Complications Trial (DCCT), to assess the association of short-term and intermediate glycemia on microvascular and macrovascular complications in persons with type 1 diabetes. Over a mean of 6.5 years of follow-up, this paper reported similar associations of HbA1c and glycated albumin with microvascular complications.PubMedCrossRef

29.••

Selvin E, Rawlings AM, Grams M, et al. Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2014;2(4):279–88. doi:10.1016/S2213-8587(13)70199-2. This has been the largest population-based study, with the longest follow-up, to assess prospective associations of fructosamine and glycated albumin with incident diabetes and microvascular outcomes in persons with and without diabetes. This study included more than 12,000 participants (nearly 1,000 with diabetes), who were followed for about 20 years.PubMedCrossRef

30.

Yang C, Li H, Wang Z, et al. Glycated albumin is a potential diagnostic tool for diabetes mellitus. Clin Med (Northfield Il). 2012;12(6):568–71. doi:10.7861/clinmedicine.12-6-568.CrossRef

31.

Beck R, Steffes M, Xing D, et al. The interrelationships of glycemic control measures: HbA1c, glycated albumin, fructosamine, 1,5-anhydroglucitrol, and continuous glucose monitoring. Pediatr Diabetes. 2011;12(8):690–5. doi:10.1111/j.1399-5448.2011.00764.x.PubMedCentralPubMedCrossRef

32.

Jung CH, Hwang Y-C, Kim KJ, et al. Development of an HbA1c-based conversion equation for estimating glycated albumin in a Korean population with a wide range of glucose intolerance. PLoS One. 2014;9(4):e95729. doi:10.1371/journal.pone.0095729.PubMedCentralPubMedCrossRef

33.

Inoue K, Tsujimoto T, Yamamoto-Honda R, et al. A newer conversion equation for the correlation between HbA1c and glycated albumin. Endocr J. 2014. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24681757. Accessed 4 May 2014.

34.

Tahara Y. Analysis of the method for conversion between levels of HbA1c and glycated albumin by linear regression analysis using a measurement error model. Diabetes Res Clin Pract. 2009;84(3):224–9. doi:10.1016/j.diabres.2009.03.014.PubMedCrossRef

35.

Selvin E, Rawlings AM, Grams M, Klein R, Steffes M, Coresh J. Association of 1,5-Anhydroglucitol with Diabetes and Microvascular Conditions. Clin Chem. 2014. doi:10.1373/clinchem.2014.229427

36.

Gambino R. Glucose. A simple molecule that is not simple to quantify. Clin Chem. 2007;53(12):2040–1. doi:10.1373/clinchem.2007.094466.

37.

Selvin E, Francis LM, Ballantyne CM, et al. Nontraditional markers of glycemia: associations with microvascular conditions. Diabetes Care. 2011;34(4):960–7. doi:10.2337/dc10-1945.PubMedCentralPubMedCrossRef

38.

He B-B, Wei L, Gu Y-J, et al. Factors associated with diabetic retinopathy in Chinese patients with type 2 diabetes mellitus. Int J Endocrinol. 2012;2012:157940. doi:10.1155/2012/157940.PubMedCentralPubMed

39.

Morita S, Kasayama S, Deguchi R, et al. Glycated albumin, rather than Hba1c, reflects diabetic retinopathy in patients with type 2 diabetes mellitus. J Diabetes Metab. 2013;4(6):4–7. doi:10.4172/2155-6156.1000278.CrossRef

40.

Mukai N, Yasuda M, Ninomiya T, et al. Thresholds of various glycemic measures for diagnosing diabetes based on prevalence of retinopathy in community-dwelling Japanese subjects: the Hisayama Study. Cardiovasc Diabetol. 2014;13(1):45. doi:10.1186/1475-2840-13-45.PubMedCentralPubMedCrossRef

41.

Furusyo N, Koga T, Ai M, et al. Plasma glycated albumin level and atherosclerosis: results from the Kyushu and Okinawa Population Study (KOPS). Int J Cardiol. 2013;167(5):2066–72. doi:10.1016/j.ijcard.2012.05.045.PubMedCrossRef

42.

Kondaveeti SB, Kumaraswamy D, Mishra S, Kumar RA, Shaker IA. Evaluation of glycated albumin and microalbuminuria as early risk markers of nephropathy in type 2 diabetes mellitus. J Clin Diagn Res. 2013;7(7):1280–3. doi:10.7860/JCDR/2013/5145.3117.PubMedCentralPubMed

43.

Shen Y, Pu LJ, Lu L, Zhang Q, Zhang RY, Shen WF. Serum advanced glycation end-products and receptors as prognostic biomarkers in diabetics undergoing coronary artery stent implantation. Can J Cardiol. 2012;28(6):737–43. doi:10.1016/j.cjca.2012.08.015.PubMedCrossRef

44.

Lu L, Pu LJ, Xu XW, et al. Association of serum levels of glycated albumin, C-reactive protein and tumor necrosis factor-alpha with the severity of coronary artery disease and renal impairment in patients with type 2 diabetes mellitus. Clin Biochem. 2007;40(11):810–6. doi:10.1016/j.clinbiochem.2007.03.022.PubMedCrossRef

45.

Jin C, Lu L, Zhang RY, et al. Association of serum glycated albumin, C-reactive protein and ICAM-1 levels with diffuse coronary artery disease in patients with type 2 diabetes mellitus. Clin Chim Acta. 2009;408(1–2):45–9. doi:10.1016/j.cca.2009.07.003.PubMedCrossRef

46.

Lu L, Pu LJ, Zhang Q, et al. Increased glycated albumin and decreased esRAGE levels are related to angiographic severity and extent of coronary artery disease in patients with type 2 diabetes. Atherosclerosis. 2009;206(2):540–5. doi:10.1016/j.atherosclerosis.2008.12.045.PubMedCrossRef

47.

Lu L, Jin Pu L, Chen QJ, et al. Increased glycated albumin and decreased esRAGE concentrations are associated with in-stent restenosis in Chinese diabetic patients. Clin Chim Acta. 2008;396(1–2):33–7. doi:10.1016/j.cca.2008.06.019.PubMedCrossRef

48.

Song SO, Kim KJ, Lee B-W, Kang ES, Cha BS, Lee HC. Serum glycated albumin predicts the progression of carotid arterial atherosclerosis. Atherosclerosis. 2012;225(2):450–5. doi:10.1016/j.atherosclerosis.2012.09.005.PubMedCrossRef

49.

Moon JH, Chae MK, Kim KJ, et al. Decreased endothelial progenitor cells and increased serum glycated albumin are independently correlated with plaque-forming carotid artery atherosclerosis in type 2 diabetes patients without documented ischemic disease. Circ J. 2012;76(9):2273–9. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22664650. Accessed 4 May 2014.PubMedCrossRef

50.

Shen Y, Pu LJ, Lu L, Zhang Q, Zhang RY, Shen WF. Glycated albumin is superior to hemoglobin A1c for evaluating the presence and severity of coronary artery disease in type 2 diabetic patients. Cardiology. 2012;123(2):84–90. doi:10.1159/000342055.PubMedCrossRef

51.

Shen Y, Lu L, Ding FH, et al. Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion. Cardiovasc Diabetol. 2013;12(1):165. doi:10.1186/1475-2840-12-165.PubMedCrossRef

52.

Fujiwara T, Yoshida M, Yamada H, et al. Lower 1,5-anhydroglucitol is associated with denovo coronary artery disease in patients at high cardiovascular risk. Heart Vessels. 2014. doi:10.1007/s00380-014-0502-y.

53.

Kim WJ, Park CY, Park SE, et al. Serum 1,5-anhydroglucitol is associated with diabetic retinopathy in type 2 diabetes. Diabet Med. 2012;29(9):1184–90. doi:10.1111/j.1464-5491.2012.03613.x.PubMedCrossRef

54.

Watanabe K, Suzuki T, Ouchi M, et al. Relationship between postprandial glucose level and carotid artery stiffness in patients without diabetes or cardiovascular disease. BMC Cardiovasc Disord. 2013;13(1):11. doi:10.1186/1471-2261-13-11.PubMedCentralPubMedCrossRef

55.

Cohen RM, LeCaire TJ, Lindsell CJ, Smith EP, D’Alessio DJ. Relationship of prospective GHb to glycated serum proteins in incident. Diabetes Care. 2008;31(1):151–3. doi:10.2337/dc07-1465.Additional.PubMedCrossRef

56.

Cardoso CRL, Salles GF. Predictors of development and progression of microvascular complications in a cohort of Brazilian type 2 diabetic patients. J Diabetes Complications. 2008;22(3):164–70. doi:10.1016/j.jdiacomp.2007.02.004.PubMedCrossRef

55.•

Watanabe M, Kokubo Y, Higashiyama A, Ono Y, Miyamoto Y, Okamura T. Serum 1,5-anhydro-D-glucitol levels predict first-ever cardiovascular disease: an 11-year population-based cohort study in Japan, the Suita study. Atherosclerosis. 2011;216(2):477–83. doi:10.1016/j.atherosclerosis.2011.02.033. This was a large population-based prospective study with long-term follow-up. It included approximately 2,000 persons (only about 30 people with diabetes) and assessed the association of 1,5-AG with incident cardiovascular events over about 11 years.PubMedCrossRef

58.

Colagiuri S, Dickinson S, Girgis S, Colagiuri R. National evidence based guideline for blood glucose control in type 2 diabetes. Diabetes Aust NHMRC. 2009.

59.

Kesavadev J, Sadikot S, Wangnoo S, et al. Consensus guidelines for glycemic monitoring in type 1/type 2 & GDM. Diabetes Metab Syndr Clin Res Rev. 2014. doi:10.1016/j.dsx.2014.04.030.

60.

Sacks DB, Arnold M, Bakris GL, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care. 2011;34(6):e61–99. doi:10.2337/dc11-9998.PubMedCentralPubMedCrossRef

61.

Type 2 diabetes: National Clinical Guideline for management in primary and secondary care (update). London: 2008.

62.

Diabetes UK Guide to diabetes: testing. Available at: http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Testing/. Accessed 20 June 2014.

63.

Association for clinical biochemistry: fructosamine (plasma, serum). Available at: http://www.acb.org.uk/docs/default-source/amalc/fructosamine-3.pdf. Accessed 20 June 2014.

64.

Araki T, Ishikawa Y, Okazaki H, et al. Introduction of glycated albumin measurement for all blood donors and the prevalence of a high glycated albumin level in Japan. J Diabetes Investig. 2012;3(6):492–7. doi:10.1111/j.2040-1124.2012.00224.x.PubMedCentralPubMedCrossRef

65.

Upton J, Lever M, Sadler WA, George PM, Boswell DR. The quality of performance of the fructosamine test. N Z Med J. 1988;101(854):606–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/3173855. Accessed 19 Apr 2014. PubMed

66.

Cefalu WT, Bell-Farrow AD, Petty M, Izlar C, Smith JA. Clinical validation of a second-generation fructosamine assay. Clin Chem. 1991;37(7):1252–6. Available at: http://www.ncbi.nlm.nih.gov/pubmed/1855298. Accessed 29 Jul 2014.PubMed

65.•

Shafi T, Sozio SM, Plantinga LC, et al. Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients. Diabetes Care. 2013;36(6):1522–33. doi:10.2337/dc12-1896. This was a large prospective cohort study of persons on hemodialysis over a median follow-up of 3.5 years, and describes associations of fructosamine and glycated albumin with clinical outcomes, which had not been previously described in this population.PubMedCentralPubMedCrossRef

68.

Executive summary: standards of medical care in diabetes–2014. Diabetes Care. 2014;37 Suppl 1(January):S5–13. doi:10.2337/dc14-S005.

69.

Shima K, Komatsu M, Noma Y, Miya K. Glycated albumin (GA) is more advantageous than hemoglobin A1c for evaluating the efficacy of sitagliptin in achieving glycemic control in patients with type 2 diabetes. Intern Med. 2014;53(8):829–35. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24739602. Accessed 4 May 2014.PubMedCrossRef

70.

Moura BP, Amorim PR, Silva BP, Franceschini SC, Reis JS, Marins JC. Effect of a short-term exercise program on glycemic control measured by fructosamine test in type 2 diabetes patients. Diabetol Metab Syndr. 2014;6(1):16. doi:10.1186/1758-5996-6-16.PubMedCentralPubMedCrossRef

71.

Yoshiuchi K, Matsuhisa M, Katakami N, et al. Glycated albumin is a better indicator for glucose excursion than glycated hemoglobin in type 1 and type 2 diabetes. Endocr J. 2008;55(3):503–7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18445997. Accessed 20 May 2014.PubMedCrossRef

72.

Suwa T, Ohta A, Matsui T, et al. Relationship between clinical markers of glycemia and glucose excursion evaluated by continuous glucose monitoring (CGM). Endocr J. 2010;57(2):135–40. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19926921. Accessed 19 May 2014.PubMedCrossRef

73.

Koga M, Murai J, Morita S, Saito H, Kasayama S. Comparison of annual variability in HbA1c and glycated albumin in patients with type 1 vs. type 2 diabetes mellitus. J Diabetes Complications. 2013;27(3):211–3. doi:10.1016/j.jdiacomp.2012.12.001.PubMedCrossRef

74.

Hirsch IB, Brownlee M. Beyond hemoglobin A1c—need for additional markers of risk for diabetic microvascular complications. JAMA. 2010;303(22):2291–2. doi:10.1001/jama.2010.785.PubMedCrossRef

75.

Clinical Guide: 1,5-Anhydroglucitol (1,5-AG) blood test. Available at: http://www.glycomark.com/docs/default-source/downloads/glycomarkclinicalguide.pdf?sfvrsn=8. Accessed 20 June 2014.

76.

Rubinow KB, Hirsch IB. Reexamining metrics for glucose control. JAMA. 2014;305(11):1132–3.CrossRef

77.

Won JC, Park C-Y, Park H-S, et al. 1,5-Anhydroglucitol reflects postprandial hyperglycemia and a decreased insulinogenic index, even in subjects with prediabetes and well-controlled type 2 diabetes. Diabetes Res Clin Pract. 2009;84(1):51–7. doi:10.1016/j.diabres.2009.01.002.PubMedCrossRef

78.

Suh S, Joung JY, Jin SM, et al. Strong correlation between glycaemic variability and total glucose exposure in type 2 diabetes is limited to subjects with satisfactory glycaemic control. Diabetes Metab. 2014. doi:10.1016/j.diabet.2014.01.006.PubMed

79.

Sun J, Dou J-T, Wang X-L, et al. Correlation between 1,5-anhydroglucitol and glycemic excursions in type 2 diabetic patients. Chin Med J (Engl). 2011;124(22):3641–5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22340217. Accessed 4 May 2014.

80.

Furusyo N, Koga T, Ai M, et al. Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study: results from the Kyushu and Okinawa Population Study (KOPS). Diabetologia. 2011;54(12):3028–36. doi:10.1007/s00125-011-2310-6.PubMedCrossRef

81.

Zhang T, He H, Yang H-L, et al. Study of glycated albumin cut-off point in diabetes mellitus and impaired glucose regulation. Sichuan Da Xue Xue Bao Yi Xue Ban. 2014;45(2):274–7. 298. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24749356. Accessed 4 May 2014.PubMed

82.

Li Q, Pan J, Ma X, et al. Combined utility of hemoglobin A1c and glycated albumin in diabetic screening. Zhonghua Yi Xue Za Zhi. 2011;91(26):1813–6. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22093780. Accessed 4 May 2014.PubMed

83.

Ma X-J, Pan J-M, Bao Y-Q, et al. Combined assessment of glycated albumin and fasting plasma glucose improves the detection of diabetes in Chinese subjects. Clin Exp Pharmacol Physiol. 2010;37(10):974–9. doi:10.1111/j.1440-1681.2010.05417.x.PubMedCrossRef

84.

Garber AJ, Handelsman Y, Einhorn D, et al. Diagnosis and management of prediabetes in the continuum of hyperglycemia: when do the risks of diabetes begin? A consensus statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists. Endocr Pract. 2008;14(7):933–46. doi:10.4158/EP.14.7.933.PubMedCrossRef

85.

Juraschek SP, Steffes MW, Miller ER, Selvin E. Alternative markers of hyperglycemia and risk of diabetes. Diabetes Care. 2012;35(11):2265–70. doi:10.2337/dc12-0787.PubMedCentralPubMedCrossRef

86.

Shipman KE, Jawad M, Sullivan KM, Ford C, Gama R. HbA1c is a reliable test for type 2 diabetes in primary care irrespective of chronic kidney disease. BMJ. 2014;348:g3780. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24942952. Accessed 25 Jul 2014.PubMedCrossRef

87.

Peacock TP, Shihabi ZK, Bleyer AJ, et al. Comparison of glycated albumin and hemoglobin A(1c) levels in diabetic subjects on hemodialysis. Kidney Int. 2008;73(9):1062–8. doi:10.1038/ki.2008.25.PubMedCrossRef

88.

Little RR, Rohlfing CL, Tennill AL, et al. Measurement of Hba(1C) in patients with chronic renal failure. Clin Chim Acta. 2013;418:73–6. doi:10.1016/j.cca.2012.12.022.PubMedCrossRef

89.

Sany D, Elshahawy Y, Anwar W. Glycated albumin versus glycated hemoglobin as glycemic indicator in hemodialysis patients with diabetes mellitus: variables that influence. Saudi J Kidney Dis Transpl. 2013;24(2):260–73. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23538348. Accessed 29 Mar 2014.

90.

Chen F-K, Sun X-F, Zhang D, et al. Glycated albumin may be a choice, but not an alternative marker of glycated hemoglobin for glycemic control assessment in diabetic patients undergoing maintenance hemodialysis. Chin Med J (Engl). 2013;126(17):3295–300. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24033952. Accessed 29 Mar 2014.

91.

Meyer L, Chantrel F, Imhoff O, et al. Glycated albumin and continuous glucose monitoring to replace glycated haemoglobin in patients with diabetes treated with haemodialysis. Diabet Med. 2013;30(11):1388–9. doi:10.1111/dme.12294.PubMedCrossRef

92.

Freedman BI, Shenoy RN, Planer JA, et al. Comparison of glycated albumin and hemoglobin A1c concentrations in diabetic subjects on peritoneal and hemodialysis. Perit Dial Int. 2010;30(1):72–9. doi:10.3747/pdi.2008.00243.PubMedCrossRef

93.

Nagayama H, Inaba M, Okabe R, et al. Glycated albumin as an improved indicator of glycemic control in hemodialysis patients with type 2 diabetes based on fasting plasma glucose and oral glucose tolerance test. Biomed Pharmacother. 2009;63(3):236–40. doi:10.1016/j.biopha.2008.04.002.PubMedCrossRef

94.

Park H-I, Kim YS, Lee J, Kim Y, Shin SJ. Performance characteristics of glycated albumin and its clinical usefulness in diabetic patients on hemodialysis. Korean J Lab Med. 2009;29(5):406–14. doi:10.3343/kjlm.2009.29.5.406.PubMedCrossRef

95.

Yamada S, Inaba M, Shidara K, et al. Association of glycated albumin, but not glycated hemoglobin, with peripheral vascular calcification in hemodialysis patients with type 2 diabetes. Life Sci. 2008;83(13–14):516–9. doi:10.1016/j.lfs.2008.08.001.PubMedCrossRef

96.

Kumeda Y, Inaba M, Shoji S, et al. Significant correlation of glycated albumin, but not glycated haemoglobin, with arterial stiffening in haemodialysis patients with type 2 diabetes. Clin Endocrinol (Oxf). 2008;69(4):556–61. doi:10.1111/j.1365-2265.2008.03202.x.CrossRef

97.

Mittman N, Desiraju B, Fazil I, et al. Serum fructosamine versus glycosylated hemoglobin as an index of glycemic control, hospitalization, and infection in diabetic hemodialysis patients. Kidney Int Suppl. 2010;117:S41–5. doi:10.1038/ki.2010.193.PubMedCrossRef

98.

Murea M, Moran T, Russell GB, et al. Glycated albumin, not hemoglobin A1c, predicts cardiovascular hospitalization and length of stay in diabetic patients on dialysis. Am J Nephrol. 2012;36(5):488–96. doi:10.1159/000343920.PubMedCrossRef

99.

Ding FH, Lu L, Zhang RY, et al. Impact of elevated serum glycated albumin levels on contrast-induced acute kidney injury in diabetic patients with moderate to severe renal insufficiency undergoing coronary angiography. Int J Cardiol. 2013;167(2):369–73. doi:10.1016/j.ijcard.2011.12.101.PubMedCrossRef

100.

Fukuoka K, Nakao K, Morimoto H, et al. Glycated albumin levels predict long-term survival in diabetic patients undergoing haemodialysis. Nephrology (Carlton). 2008;13(4):278–83. doi:10.1111/j.1440-1797.2007.00864.x.CrossRef

99.••

Freedman BI, Andries L, Shihabi ZK, et al. Glycated albumin and risk of death and hospitalizations in diabetic dialysis patients. Clin J Am Soc Nephrol. 2011;6(7):1635–43. doi:10.2215/CJN.11491210. This was one of the first prospective studies to assess associations of glycated albumin with clinical outcomes in a population of persons with diabetes and ESRD. It included 444 participants with diabetes and included follow-up just over 2 years.PubMedCrossRef

102.

Isshiki K, Nishio T, Isono M, et al. Glycated albumin predicts the risk of mortality in type 2 diabetic patients on hemodialysis: evaluation of a target level for improving survival. Ther Apher Dial. 2013. doi:10.1111/1744-9987.12123.PubMed

103.

Ma W-Y, Wu C-C, Pei D, et al. Glycated albumin is independently associated with estimated glomerular filtration rate in nondiabetic patients with chronic kidney disease. Clin Chim Acta. 2011;412(7–8):583–6. doi:10.1016/j.cca.2010.12.013.PubMedCrossRef

104.

Okada T, Nakao T, Matsumoto H, et al. Influence of proteinuria on glycated albumin values in diabetic patients with chronic kidney disease. Intern Med. 2011;50(1):23–9. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21212569. Accessed 24 May 2014.PubMedCrossRef

105.

Chen H-S, Wu T-E, Lin H-D, et al. Hemoglobin A(1c) and fructosamine for assessing glycemic control in diabetic patients with CKD stages 3 and 4. Am J Kidney Dis. 2010;55(5):867–74. doi:10.1053/j.ajkd.2009.10.064.PubMedCrossRef

106.

Kim WJ, Park C-Y, Lee K-B, et al. Serum 1,5-anhydroglucitol concentrations are a reliable index of glycemic control in type 2 diabetes with mild or moderate renal dysfunction. Diabetes Care. 2012;35(2):281–6. doi:10.2337/dc11-1462.PubMedCentralPubMedCrossRef

107.

Kim S, Min W-K, Chun S, Lee W, Park H-I. Glycated albumin may be a possible alternative to hemoglobin A1c in diabetic patients with anemia. Clin Chem Lab Med. 2011;49(10):1743–7. doi:10.1515/CCLM.2011.646.PubMedCrossRef

108.

Koga M, Hashimoto K, Murai J, et al. Usefulness of glycated albumin as an indicator of glycemic control status in patients with hemolytic anemia. Clin Chim Acta. 2011;412(3–4):253–7. doi:10.1016/j.cca.2010.10.014.PubMedCrossRef

109.

Sugimoto T, Hashimoto M, Hayakawa I, et al. Alterations in HbA1c resulting from the donation of autologous blood for elective surgery in patients with diabetes mellitus. Blood Transfus. 2014;12 Suppl 1:s209–13. doi:10.2450/2013.0271-12.PubMedCentralPubMed

110.

Kim PS, Woods C, Georgoff P, et al. A1C underestimates glycemia in HIV infection. Diabetes Care. 2009;32(9):1591–3. doi:10.2337/dc09-0177.PubMedCentralPubMedCrossRef

111.

Koga M, Kasayama S, Kanehara H, Bando Y. CLD (chronic liver diseases)-HbA1C as a suitable indicator for estimation of mean plasma glucose in patients with chronic liver diseases. Diabetes Res Clin Pract. 2008;81(2):258–62. doi:10.1016/j.diabres.2008.04.012.PubMedCrossRef

112.

Bando Y, Kanehara H, Toya D, Tanaka N, Kasayama S, Koga M. Association of serum glycated albumin to haemoglobin A1C ratio with hepatic function tests in patients with chronic liver disease. Ann Clin Biochem. 2009;46(Pt 5):368–72. doi:10.1258/acb.2009.008231.PubMedCrossRef

113.

Koga M, Murai J, Saito H, et al. 1,5-Anhydroglucitol levels are low irrespective of plasma glucose levels in patients with chronic liver disease. Ann Clin Biochem. 2011;48(Pt 2):121–5. doi:10.1258/acb.2010.010053.PubMedCrossRef

114.

Hashimoto K, Noguchi S, Morimoto Y, et al. A1C but not serum glycated albumin is elevated in late pregnancy owing to iron deficiency. Diabetes Care. 2008;31(10):1945–8. doi:10.2337/dc08-0352.PubMedCentralPubMedCrossRef

115.

Hashimoto K, Osugi T, Noguchi S, et al. A1C but not serum glycated albumin is elevated because of iron deficiency in late pregnancy in diabetic women. Diabetes Care. 2010;33(3):509–11. doi:10.2337/dc09-1954.PubMedCentralPubMedCrossRef

116.

Metzger BE, Lowe LP, Dyer AR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002. doi:10.1056/NEJMoa0707943.PubMedCrossRef

Title: Beyond HbA1c and Glucose: the Role of Nontraditional Glycemic Markers in Diabetes Diagnosis, Prognosis, and Management
Authors: Christina M. Parrinello
Elizabeth Selvin
Publication date: 01-11-2014
Publisher: Springer US
Published in: Current Diabetes Reports / Issue 11/2014
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-014-0548-3

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2014

Predictors of Self-Management in Pediatric Type 1 Diabetes: Individual, Family, Systemic, and Technologic Influences

Overlap of Genetic Susceptibility to Type 1 Diabetes, Type 2 Diabetes, and Latent Autoimmune Diabetes in Adults

Type 2 Diabetes: Is Pancreas Transplantation an Option?

Assessing Premorbid Cognitive Ability in Adults With Type 2 Diabetes Mellitus—a Review With Implications for Future Intervention Studies

Insights into the Genetic Susceptibility to Type 2 Diabetes from Genome-Wide Association Studies of Glycaemic Traits

Microvascular Dysfunction in the Context of Diabetic Neuropathy

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage