Fructosamine

Fructosamine and A1C tests are used primarily as monitoring blood sugar in diabetics.

Fructosamine may be useful in situations where the A1C cannot be reliably measured.

Advantages of fructosamine testing are: Low cost, useful in settings where HbA1C is questionable, and useful for assessing short-term, 2 – to 4-week, glycemic control,

Allows the effectiveness of diet or medication adjustments to be evaluated after a couple of weeks rather than months.

During pregnancy fructosamine measurements may be ordered along with glucose levels to help monitor and accommodate shifting glucose and insulin requirements.

Can be utilized in clinical situations that affects the average age of red blood cells, such as hemolytic anemia or blood loss.

In the presence of some hemoglobin variants fructosamine can be used to monitor glucose control more effectively than HbA1c.

Fructosamine is made when a protein, usually albumin, has a chemical reaction with glucose.

Fructosamine and glycated albumin are strongly associated with retinopathy and predict development of CKD nearly as well as HbA1C.

Fructosamine is formed when glucose binds to total serum proteins, mostly albumin.

Glycated albumin is produced when glucose bonds to albumin.

Neither are affected by erythrocyte or hemoglobin characteristics.

The amount of glycosylated protein reflects the average available quantity of blood glucose during this period.

Fructosamine creation is dependent on serum protein glycation, so the results are unaffected by the presence of hemoglobinopathy.

It is a measurement of the average blood glucose concentration for the past 2-3 weeks.

Fructosamine, reflects the physiology of glucose in the extracellular space while A1C the nonenzymatic glycation in the intracellular erythrocyte compartment:.

The difference between a measured A1c and the predicted A1c based on fructosamine is known as the glycation gap (GG).

Gllycation gap correlates to major complications of diabetic nephropathy, more strongly than just A1c alone.

Fructosamine tests are not standardized and there are no definitive criteria to use the levels for diagnosis or titration of diabetes.

Fructosamine and glycated albumin measurements could be affected by liver disease, hyperuricaemia, acute illness or infection, and thyroid dysfunction

Not useful as a screen for diabetes.

Monitors a patient’s average glucose levels over the previous 2 to 3 weeks.

Primarily ordered when a diabetic treatment plan is being instituted or altered in order to monitor the effect of the change in diet or medication.

The higher the fructosamine concentration the higher the average blood glucose level.

A normal fructosamine level indicates a diabetic has good control or the patient is not diabetic.

Falsely low levels may be seen with decreased blood total protein and/or albumin levels.

High levels of vitamin C, lipemia, hemolysis, and hyperthyroidism can interfere with test results.

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