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PubMed1995

Glycated blood proteins in canine diabetes mellitus.

Measurements of serum fructosamine and glycated haemoglobin are increasingly used to complement plasma glucose concentration in the fasting dog to diagnose diabetes mellitus and to monitor the response to treatment. These measurements are not affected by acute changes in the glucose concentration and reflect the average plasma glucose concentration over the preceding one to two weeks in the case of serum fructosamine and two to three months in the case of glycated haemoglobin. Both components can be measured in canine blood samples, but glycated haemoglobin is still not measured routinely; however, the serum fructosamine concentration can be measured accurately by means of simple spectrophotometric assays. The sensitivity and specificity of serum fructosamine in diagnosing diabetes mellitus in dogs with clinical signs of the disease are very high (0.93 and 0.95, respectively). Furthermore, serum fructosamine can be used as a reliable screening test to identify diabetic dogs in an average middle-aged to older hospital population. In addition, serum fructosamine can distinguish between hyperglycaemic non-diabetic dogs and hyperglycaemic diabetic dogs. Preliminary data suggest that therapy can be safely monitored and regulated on the basis of serial measurements of the serum fructosamine concentration in diabetic dogs.

Animals↗
PubMed1993

Biological variation in glycated proteins.

The high degree of individuality in the fructosamine assay has been ascribed to non-specific interferences in the assay. To investigate this, we measured the biological variability of 10 non-diabetic subjects using the fructosamine assay, the new fructosamine plus assay, glycated albumin and glycated total plasma proteins by affinity chromatography. The total variation of the two fructosamine assays was half that of the affinity chromatography assays. This was mainly due to the greater analytical imprecision of the affinity chromatography assays. The resulting high index of heterogeneity for both affinity methods makes it difficult to assess the significance of changes in serial results. The within-subject variation made a small contribution to the total variation for all the assays, and was particularly low for the fructosamine assays. This suggests that any non-specific component makes a constant contribution to the measured fructosamine activity in non-diabetic subjects. The fructosamine assays therefore have significant advantages over the affinity chromatography methods as indices of medium-term glycaemic control.

Adolescent↗
PubMed2004

The effect of glycemic control in type 2 diabetic patients with diabetes-related dyslipidemia.

OBJECTIVE: The study was planned to investigate whether the serum lipid profile in type 2 diabetes mellitus was different between groups of patients classified as having good, satisfactory or poor glycemic controls, depending on their serum fructosamine levels. METHODS: The study was carried out in the Department of Laboratory, Dammam College for Health Sciences, Dammam, Kingdom of Saudi Arabia between February 2003 to June 2003. Clinical laboratory data from diagnosed type 2 diabetic patients were used in the study. One hundred and nineteen patient's data were randomly selected, and according to their serum fructosamine levels, the patients were divided into 3 groups: 29 patients classified as patients with good glycemic control (GGC) with serum fructosamine level <250 micromol/L, 44 patients classified as satisfactory glycemic control (SGC) with serum fructosamine level ranging between 250-355 micromol/L and 46 patients classified as poor glycemic control (PGC) with serum fructosamine >355 micromol/L. The fasting serum glucose and various lipids and lipoprotein concentrations of each group were analyzed by one way analysis of variance and regression analysis. RESULTS: In the PGC group, the serum total cholesterol (6.11+/- 1.56 mmol/l), triglyceride (2.13 +/- 0.71 mmol/L) and very low density lipoprotein-cholesterol (1.09 +/- 0.40 mmol/L) concentrations were significantly higher than that of the SGC (5.59 +/- 0.89, 1.59 +/- 0.38 and 0.86 +/- 0.28 mmol/L,), and the GGC (5.11 +/- 1.06, 1.25 +/- 0.32 and 0.78 +/- 0.29 mmol/L), whereas, those of the SGC were slightly raised, but not statistically significant, compared to the GGC. The high density lipoprotein cholesterol was significantly lower, and the low density lipoprotein cholesterol was elevated in both satisfactory and poorly controlled groups compared to good control group. Significant correlations were evident between the serum fructosamine and glucose concentrations (r=0.79, p<0.0001), and between them as independent parameters and the serum lipid concentrations. CONCLUSION: The glycemic control in type 2 diabetes significantly improves diabetic related dyslipidemia, and would be expected to reduce the risk of atherosclerosis. It is also worth mentioning that the serum fructosamine measure gives a good index for the glycemic control, and its value can reflect the profile of serum lipids.

Adult↗
PubMed1993

Role of glycated proteins in detecting and monitoring diabetes in cynomolgus monkeys.

The use of glycated serum protein testing, as measured by serum fructosamine, to detect and monitor the diabetic state in 363 cynomolgus monkeys (Macaca fascicularis) consuming either standard diet or atherogenic diet was evaluated. Reference ranges were also established in 142 rhesus monkeys (M. mulatta) and 55 stumptail monkeys (M. arctoides). Values for serum fructosamine in all species ranged from approximately 0.5 to 2 mMol/liter. After determining the colony mean for each species and diet group, four cynomolgus monkeys were found to have serum fructosamine levels more than two standard deviations above the mean, whereas all values were normal in the rhesus and stumptail monkey colonies. These four animals were determined to be diabetic by repeated fasting glucose determinations and intravenous glucose tolerance testing. Serum fructosamine values correlated significantly with glycated hemoglobin (r = 0.61, P < 0.001) and fasting blood glucose (r = 0.70, P < 0.001) determinations in all diabetic and nondiabetic monkeys. The usefulness of serum fructosamine testing to monitor longitudinal glycemic control was also evaluated. Fasting blood glucose and fructosamine values for five previously diagnosed diabetic and five nondiabetic monkeys determined at 2-week intervals over a 20-week period correlated significantly (r = 0.75, P < 0.001). In conclusion, serum fructosamine may provide an objective parameter of antecedent glycemic control in nonhuman primates.

Animals↗
PubMed2002

Determinants of glycated LDL levels in nondiabetic and diabetic hyperlipidaemic patients in Kuwait.

BACKGROUND: Glycation and oxidative modification of lipoproteins enhance the uptake of these lipids by macrophages in the early stages of atherogenesis. Measurement of blood levels of modified LDL particles could thus constitute another useful modality in identifying subjects at high risk of coronary atherosclerosis (CHD). OBJECTIVE: To measure the glycated LDL level and assess its associations with other metabolic parameters in diabetic and nondiabetic hyperlipidaemic subjects attending a Lipid Clinic in Kuwait. SUBJECTS AND METHODS: One hundred thirty-three hyperlipidaemic (HL) (72 nondiabetic (ND); 61 diabetic (D)) patients and 42 healthy control (HC) subjects had their fasting serum samples analyzed for glucose, total cholesterol (TC), triglycerides (TG), urate, HDL, LDL (by routine autoanalyzer methods), apolipoproteins A1 and B (by nephelometry), fructosamine (by spectrophotometry) and glycated LDL (gLDL) by ELISA. RESULTS: The serum gLDL level was significantly higher in HL [D+ND] than in HC (p<0.001). Within the HL group, the DHL patients had higher levels than the NDHL [p<0.001]. These differences were maintained when the gLDL level was also expressed as a percentage of the apo B concentration. The gLDL level correlated positively (p<0.01) with those of glucose, TC, TG and LDL and negatively with HDL (p<0.05) in all the subjects as a whole, healthy and hyperlipidaemia [HC+HL]. In the HL (D+ND) group as a whole, gLDL correlated significantly only with glucose [p<0.01]. In group DHL, however, gLDL correlated significantly with glucose, fructosamine and LDL [all p<0.05]. As expected, fructosamine levels were highest in the DHL group. The significant correlations established between fructosamine and the different analytes measured in the different subject groups were essentially similar to those observed for gLDL, except for the finding of persistent significant negative correlations of fructosamine with LDL in all the subject groups. CONCLUSIONS: (i) Serum gLDL levels are increased in hyperlipidaemic patients and are further increased with diabetes, suggesting that the significant glycation of LDL occurs in all hyperlipidaemic patients irrespective of their glycaemic status. (ii) The significant correlation of gLDL with glucose and fructosamine in diabetic patients would suggest its potential utility as another index of medium term glycaemic control. (iii) gLDL is easily measurable and its values could provide additional information in ascertaining an individual's aggregate CHD risk.

Adult↗
PubMed2005

Glycemic monitoring in diabetics with sickle cell plus beta-thalassemia hemoglobinopathy.

OBJECTIVE: To report a case of diabetes management in a patient with a hemoglobinopathy that caused her clinician to seek a different measure of glycemic control, fructosamine, rather than glycosylated hemoglobin (HbA1c). CASE SUMMARY: A 53-year-old African American woman presented with a past medical history of type 2 diabetes, hypertension, seizure disorder, rheumatoid arthritis, and sickle cell disease plus beta-thalassemia. She reported fasting blood glucose values ranging broadly from 50 to 320 mg/dL, yet her HbA1c result remained steady in a low range of <6%. A measure of fructosamine returned elevated at 340 micromol/L (reference range 200-300). DISCUSSION: We believe that this patient's hemoglobinopathy resulted in falsely low levels of HbA1c, and we substantiate this interpretation with the patient's self-monitored blood glucose values from home that appeared higher and inconsistent with the HbA1c results. Although few reports on using the measure of fructosamine appear in the literature, this patient's high fructosamine result supports fructosamine as the more appropriate measure of glycemic control. CONCLUSIONS: Serum fructosamine levels may be considered as an appropriate laboratory measurement when monitoring long-term glycemic control in patients with type 2 diabetes mellitus and sickle cell disease.

Anemia, Sickle Cell↗
PubMed2002

[Transcapillary filtration of plasma proteins in patients with diabetes type II microangiopathy complications].

UNLABELLED: This study presents the results of the research on transcapillary filtration of plasma proteins in patients with non-insulin dependent diabetes mellitus (NIDDM). The aims of the study were as follows: (a) Examination of transcapillary filtration of plasma proteins in patients with NIDDM; (b) Search for correlations between metabolic status of diabetes, severity of diabetic microangiopathy and penetration of individual protein fractions into the blister fluid; (c) Examination of the influence of nonenzymatic glycation on albumin fragmentation and its transcapillary filtration. It was also decided to check whether changes in the blister fluid would appear earlier than fundal fluorescein angiography or microalbuminuria, two markers of diabetic microangiopathy. The study enrolled 34 patients with type II diabetes mellitus, aged 35-78 years, with a mean disease duration of 12.5 years (SD = 7.8). The control group included 10 non-diabetic volunteers aged 31-76 years. The mean age in both groups did not differ significantly. The cantharidin blister method was used to study the permeability of capillary vessels. The following laboratory tests were done: concentrations of serum urea, creatinine, glucose, fructosamine, glycated hemoglobin, cholesterol, and triglycerides. Electrophoretic separation of proteins in plasma and blister fluid was performed and the concentration of fructosamine in fluid was measured. Routine urinalysis was supplemented with microalbuminuria. The eye fundus was inspected and fundal fluorescein angiography was done. The influence of nonenzymatic glycation on protein fragmentation and its possible impact on the permeability of capillary vessels was determined with in vitro glycation of human serum albumin. In patients without diabetic retinopathy the Cb:Cs ratio for beta-globulin turned out to be significantly lower than in patients with proliferative retinopathy. Patients with normoalbuminuria had the Cb:Cs ratio for alpha 2-globulin significantly lower than patients with urinary albumin concentrations > or = 165 mg/L. When the group was divided with regard to serum fructosamine concentrations, the subgroup with fructosamine concentrations lower than 3 mmol/L revealed a significantly higher Cb:Cs ratio for fructosamine than the subgroup with fructosamine > or = 3 mmol/L. Concentrations of total protein, albumin, beta-globulin and gamma-globulin in blister fluid correlated positively with glycemia in the control group. Blister fluid concentration of beta-globulin correlated positively with HbAIC concentration. In the study group, total protein content in blister fluid correlated negatively with duration of diabetes and level of glycosuria. Concentrations of blister fluid alpha 1-globulin and gamma-globulin correlated negatively with glycosuria. Concentrations of blister fluid beta-globulin correlated negatively with duration of diabetes. Electrophoretic separation of in vitro SDS glycosylated human serum revealed no additional fraction in the incubated samples. Electrophoretic separation of in vitro glycosylated albumin disclosed co-migration of albumin monomers incubated for varying times with glucose. CONCLUSIONS: 1. Glycation of human serum and albumin does not cause fragmentation of the proteins, but decreases transcapillary filtration of albumin due to change of molecular electric charge. 2. Patients with non-insulin dependent diabetes and microangiopathic complications reveal increased transcapillary transport of alpha 2- and beta-globulin in skin. 3. Increased permeability of skin capillary vessels for alpha 2- and beta-globulin in diabetic microangiopathy reflects an advanced stage of the disease and may facilitate progression.

Adult↗
PubMed1999

[Cord blood erythropoietin in relation to glycemic control in the last weeks of pregnancy].

The relationship between cord blood erythropoietin (EPO) and maternal HbA1c and fructosamine levels were examined in the aim to answer a question, whether occurrence of prenatal hypoxia in newborns of diabetic mothers depends from maternal glycemic control during the last weeks of pregnancy. The study was performed in the group of 178 mothers and newborns divided into two groups: diabetic and control. The diabetic group consisted of 116 mothers (33 with IDDM and 83 with GDM) and newborns and the control group consisted of 62 healthy mothers and newborns. Maternal HbA1c (Micro Column Test BIORAD Prospecta) and fructosamine (Roche fructosamine Test) levels were estimated on the day of delivery. Cord blood to estimate EPO (radioimmunoassay) and fructosamine levels were drawing immediately after delivery the babies. The relationship between the study parameters were calculated on the basis of a covariance analysis test. In the diabetic group the significant positive correlation between EPO and maternal HbA1c and fructosamine levels was found as well as between EPO and fetal fructosamine levels. We conclude that higher levels of cord blood EPO are associated with poor maternal glycemic control during the last weeks of pregnancy.

Adult↗
PubMed1996

Glycated proteins as indices of glycaemic control in diabetic patients with chronic renal failure.

This study investigates the reliability of glycated haemoglobin, measured by electroendosmosis or by affinity chromatography, fructosamine, and albumin adjusted fructosamine, as indices of glycaemic control in Type 1 diabetes complicated by chronic renal failure. Twenty uraemic diabetic patients took part in the study, including 5 patients managed conservatively, 6 on CAPD, 3 on haemodialysis, and 6 renal transplant recipients. Results were compared with those from 15 diabetic subjects with normal renal function. In renal patients, there was significant correlation between glycated haemoglobin measured by electroendosmosis (r = 0.45; p = 0.04) or by affinity chromatography (r = 0.57; p = 0.01) and mean capillary blood glucose concentrations over the previous 6 weeks. The regression equations did not differ significantly between subjects with renal failure and those with normal renal function, suggesting that similar ranges can be used in interpreting glycated haemoglobin results from each group of patients. Patients on haemodialysis may be an exception; there was evidence that glycated haemoglobin may be misleadingly low in such subjects. Fructosamine correlated significantly with mean blood glucose concentrations measured over the previous week in patients with normal renal function (r = 0.75; p = 0.001), but not in patients with chronic renal failure (r = -0.1; p = 0.71). Calculation of an albumin adjusted fructosamine result failed to improve the correlation with blood glucose concentrations. The use of fructosamine cannot be recommended as an index of glycaemic control in uraemic patients.

Blood Glucose↗
PubMed1987

The prevalence of diabetes mellitus and an assessment of methods of detection among a community of elderly Chinese in Hong Kong.

This study provides information on the prevalence of diabetes mellitus in a group of elderly Chinese subjects aged 60 and above living in the community in Hong Kong, and investigates the sensitivity of the urine sugar, random blood glucose, glycosylated haemoglobin, and fructosamine measurements compared to a glucose tolerance test in screening for diabetes mellitus in this population. Four hundred twenty-seven subjects aged 60 and above were studied. The National Diabetes Data Group Criteria were used for the diagnosis of diabetes. Those with a random blood glucose exceeding 12.5 mmol/l were considered diabetic, and all of these patients had glycosuria together with elevated total glycosylated haemoglobin and fructosamine concentrations. A diagnostic 75 g oral glucose tolerance test was performed on patients with one or more of the following abnormalities: glycosuria, random plasma blood glucose 7.8 mmol/l to 12.5 mmol/l, glycosylated haemoglobin 8.5%, and fructosamine 2.20 mmol/l. By these criteria, the prevalence of diabetes in this community was found to be 9.8%. An elevated random glucose greater than 11.1 mmol/l proved to be the only specific method of screening and glycosuria was found to be at least as good as fructosamine and HbA1. However, HbA1 is more sensitive than random glucose, glycosuria or fructosamine in detecting impaired glucose tolerance. On the basis of this study, a higher reference range for glycosylated haemoglobin for the elderly alone is also suggested (5.74-9.34%).

Aged↗
PubMed1991

Serum fructosamine/haemoglobin A1 ratio predicts the future changes in haemoglobin A1 in type 2 (non-insulin dependent) diabetic patients.

The aim of the study was to define clinical interpretation of the parallel measurements of serum fructosamine and HbA1 in diabetic patients. We studied 14 type 2 diabetic patients over a 16-wk period. The cross-sectional analysis showed no correlation between serum fructosamine and HbA1 concentrations during the period of changing glycaemic control. The correlations, however, became significant (P less than 0.05) at 12 (r = 0.60) and 16 (r = 0.87) weeks, i.e. after glycaemia had stabilised. Longitudinal analysis of individual patients' data over the 16-wk period showed a significant correlation between serum fructosamine and HbA1 (r = 0.55 to r = 0.94) which was present in 8 out of 14 patients. The changes in fructosamine concentration preceded those observed in HbA1. The ratio of fructosamine/HbA1 predicted the changes in HbA1 over the following month (r = 0.54, P less than 0.001). Thus, we demonstrated that the parallel measurement of fructosamine and HbA1 provides information on future trends in HbA1 concentration in diabetic patients.

Adult↗
PubMed2001

Evolution of fructosaminaemia and glucaemia during the growth of unweaned and early weaned half-bred zebu calves.

The purposes of the study were to obtain the confidence intervals for serum fructosamine concentrations in unweaned and early weaned calves, to verify the changes in this glycated protein during growth, when glucaemia declines, and to assess the changes in both parameters attributable to stress or alarm. Sixty out of 120 suckling half-bred zebu calves (60-75 days old) were weaned at day 0 and then received a commercial balanced diet, while the remainder continued to suck. Blood samples were taken at 0, 7, 14, 21, 28, 60, 90 and 120 days and the serum fructosamine and glucose concentrations were measured by conventional methods. Both biochemical parameters declined with time, but there were no statistical differences between the unweaned and weaned calves. The fall in fructosamine concentration correlated significantly with the decline in glucose concentrations in both groups. The confidence interval for fructosamine concentration decreased with age, from 294-303 micromol/L at 2 months old to 215-232 micromol/L at 6 months old. At the same time, glucaemia declined from 7.5-8.6 mmol/L to 4.8-5.3 mmol/L. Acute elevations in glucaemia, especially in the younger calves, were attributed to alarms, such as those caused by handling and blood extraction. The absence of resultant increases in fructosamine concentration discounts the existence of prolonged hyperglucaemias (stress) in early weaned calves.

Animals↗
PubMed1989

An analysis of glycosylated blood proteins and blood glucose profiles over one year in patients with type 1 diabetes.

The clinical value of prospective measurement of several direct and indirect measures of blood glucose control in the management of Type 1 diabetes has been investigated. Ninety-eight Type 1 diabetic patients were followed over a period of 1 year after a 6-week period of intensification of management, with monthly measurements of blood glucose profiles and 3-monthly HbA1, glycosylated serum albumin, and fructosamine measurements. All measures improved markedly after the initial 6-week period (p less than 0.001), and all except glycosylated serum albumin and fructosamine then remained relatively stable. Of fourteen serial comparisons, glycosylated blood proteins were significantly correlated more often with levels of mean blood glucose and M value (on 4-7 occasions, rs 0.30-0.58) than with fasting blood glucose levels (on only 2-3 occasions, rs 0.34-0.44). Serum fructosamine levels correlated significantly with mean blood glucose on four occasion (rs 0.30-0.50), whilst glycosylated serum albumin and HbA1 correlated with mean blood glucose on six occasions (rs 0.36-0.54). Glycosylated serum albumin correlated with HbA1 and fructosamine levels throughout the year (rs 0.47-0.68 and 0.48-0.76, respectively), but HbA1 and fructosamine were less clearly correlated with each other (rs 0.38-0.44), with no significant association immediately after the period of intensive management or 3 months later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Separation of serum glycated proteins by agarose gel electrophoresis and nitroblue tetrazolium staining in diabetic and normal cats.

BACKGROUND: The total glycated protein (fructosamine) concentration in serum consists mainly of glycated albumin and lipoproteins. Measurement of fructosamine is used to diagnose and monitor diabetes mellitus in cats. OBJECTIVE: The aims of this study were to measure glycated proteins in diabetic and healthy (nondiabetic) cats using a semiquantitative technique and to determine whether measurement of any of the fractions of glycated protein could be potentially advantageous for the diagnosis and monitoring of diabetic cats. METHODS: Serum samples from 6 cats with diabetes mellitus and 10 clinically healthy adult cats were assayed for total glycated protein using a nitroblue tetrazolium (NBT) fructosamine assay. Serum proteins were separated by agarose gel electrophoresis and stained with NBT to identify individual glycated proteins within the bands. Gels were scanned by densitometry at 525 nm and the glycated protein content was calculated with reference to the total glycated protein content of the sample. RESULTS: Diabetic cats with increased total fructosamine concentrations had higher concentrations of glycated albumin and glycated alpha- and beta-lipoproteins compared with healthy cats. The concentration of glycated proteins in each of the fractions had a positive linear association with the total glycated protein content of serum, but there was large variation in the relative contributions of the 3 protein fractions to the total glycated protein concentration. CONCLUSIONS: Based on the results of this study, measurement of individual glycated fractions does not seem to offer any potential diagnostic advantage over measurement of total glycated protein (fructosamine) concentration alone. In some diabetic and healthy cats, glycated lipoproteins formed the major part of the total glycated protein, whereas in other cats albumin was the major contributor.

Animals↗
PubMed1998

Pramlintide, a synthetic analog of human amylin, improves the metabolic profile of patients with type 2 diabetes using insulin. The Pramlintide in Type 2 Diabetes Group.

OBJECTIVE: To examine the effects of 4 weeks of subcutaneous administration of pramlintide, a synthetic analog of human amylin, on metabolic control in patients with type 2 diabetes using insulin. RESEARCH DESIGN AND METHODS: Serum fructosamine, HbA1c, and fasting plasma lipids were measured in 203 patients in a randomized double-blind placebo-controlled parallel-group multicenter trial using doses of 30 micrograms q.i.d., 60 micrograms t.i.d., and 60 micrograms q.i.d. RESULTS: Statistically significant reductions in serum fructosamine concentrations were observed in the pramlintide 30 micrograms q.i.d. group (17.5 +/- 4.9 mumol/l, P = 0.029), the pramlintide 60 micrograms t.i.d. group (24.1 +/- 4.9 mumol/l, P = 0.003), and the 60 micrograms q.i.d. group (22.6 +/- 4.1 mumol/l, P = 0.001) compared with the placebo group (3.5 +/- 3.8 mumol/l). There were also statistically significant shifts in the proportion of patients with an abnormal serum fructosamine concentration at baseline that normalized at week 4 within the pramlintide 60 micrograms t.i.d. group and the 60 micrograms q.i.d. group. Consistent with the fructosamine results, there were statistically significant reductions in HbA1c in the pramlintide 30 micrograms q.i.d. group (0.53 +/- 0.07%, P = 0.0447), the pramlintide 60 micrograms t.i.d. group (0.58 +/- 0.07%, P < 0.0217), and the pramlintide 60 micrograms q.i.d. group (0.51 +/- 0.08%, P = 0.0242) compared with the placebo group (0.27 +/- 0.08%). Total cholesterol concentrations were also statistically significantly reduced in both the pramlintide 60 micrograms t.i.d. group (8.4 mg/dl, P < 0.01) and 60 micrograms q.i.d. group (10.5 mg/dl, P < 0.01) compared with placebo (1.2 mg/dl). Body weight decreased in both of the pramlintide 60 micrograms groups, but the trend did not achieve statistical significance. The incidence of hypoglycemia was similar in all treatment groups. CONCLUSIONS: Reductions in serum fructosamine, plasma total and LDL cholesterol concentrations, and HbA1c support the hypothesis that pramlintide may improve metabolic control in patients with type 2 diabetes using insulin.

Adult↗
PubMed1992

Has the process causing noninsulin dependent diabetes start at birth? Evidence in neonates from a population with a high prevalence of diabetes.

AIMS: to investigate whether differences in the glucose-insulin axis are present at birth in neonates from ethnic groups at high risk of diabetes. METHODS: fructosamine samples were taken from Maori, European and Pacific Island expectant mothers at their 28 week appointment at the public outpatients clinic at National Women's Hospital, Auckland. Umbilical cord samples for insulin, C-peptide and fructosamine assay were taken at delivery and babies had their subscapular skinfold fat thickness measured by callipers. RESULTS: the mean maternal 28 week fructosamine was similar in the three populations in spite of a higher prevalence of gestational diabetes among Pacific Islanders. Of the 1066 deliveries, cord samples were available for 207 Europeans, 81 Maoris and 113 Pacific Islanders. Both Pacific Island and Maori babies had higher cord fructosamine concentrations than European babies. However, Pacific Island babies were also heavier, and had higher cord insulin concentrations and subscapular skinfold thickness than European babies. CONCLUSIONS: the elevated cord fructosamine concentrations suggest that Maori and Pacific Island babies, who share a high risk of noninsulin dependent diabetes mellitus later in life, are hyperglycaemic at birth. The paradoxical insulin results and the cause for the relative neonatal hyperglycemia warrant further investigation.

Adult↗
PubMed1993

Specific glycation of albumin depends on its half-life.

Some suggest that measurements of plasma fructosamine concentration should be corrected for the plasma protein (or albumin) concentration because the extent of glycation per volume depends on both protein and glucose concentrations. Several reports, however, demonstrate a poor correlation between plasma fructosamine and albumin concentrations in diabetic patients. In vitro kinetic and in vivo studies have shown that glycation is also dependent on the half-lives of plasma proteins. Because a decrease in plasma albumin diminishes its catabolism, we speculated that low albumin concentrations are associated with a greater extent of glycation on a molar basis (specific glycation) and vice versa. To test this hypothesis, we studied plasma albumin, total protein, and fructosamine in 63 nondiabetic subjects with normal plasma fasting glucose concentrations and hemoglobin A1c between 5.1% and 5.9%. Plasma fructosamine was poorly correlated with albumin concentration (r = 0.348) but a logarithmic plot of the specific glycation of albumin vs albumin concentration showed a better correlation (r = -0.842), suggesting that the kinetic considerations were operating in vivo. Therefore, because lower specific glycation of plasma albumin "compensates" for higher concentration, correction of fructosamine for albumin content in patients will overestimate mean blood glucose when albumin is low and underestimate it when albumin is high.

Blood Glucose↗
PubMed1996

Current state of metabolic control achieved in a New Zealand diabetes clinic.

AIMS: To report on current degree of metabolic control achieved in diabetic patients in a New Zealand diabetes clinic. METHODS: All metabolic data were reviewed for patients attending the Waikato diabetes clinic from 1 January 1992 to 1 January 1995. Values were obtained from 409 insulin treated patients (IDDM), with a mean age of 39 (SD 15 yr); 200 patients who transferred from diet or pills to insulin (NIDDM-I) with a mean age of 59 (SD 12 yr); and 290 noninsulin dependent patients (NIDDM), mean age 54 (SD 13 yr). Results. Percentage of fructosamine values in the normal range: IDDM 10%, NIDDM-I 12.5% and NIDDM 37.9%. Mean values (SD). IDDM group: fructosamine 376 (78) mmol/L, cholesterol 5.24 (1.1) mmol/L, HDL cholesterol 1.47 (0.45) mmol/L, triglycerides 1.71 (1.35) mmol/L. NIDDM-I group: fructosamine 359 (67) mmol/L, cholesterol 5.82 (1.1) mmol/L, HDL cholesterol 1.21 (0.45) mmol/L, triglycerides 2.92 (3.8) mmol/L. NIDDM group: fructosamine, 312 (73) mmol/L, cholesterol 5.83 (1.24) mmol/L, HDL cholesterol 1.1 (0.33) mmol/L, triglycerides 3.11 (3.59) mmol/L. Percentage of smokers in each group: IDDM 24%, NIDDM-I 8.5%, NIDDM 17.2%. CONCLUSIONS: the majority of patients fail to achieve normal fructosamine values. Lipid control is poor, other than in the IDDM group. A significant number of patients continue to smoke. Considerable scope for improvement is noted.

Adult↗