Glycated Albumin is a Better Indicator for Glucose Excursion than Glycated Hemoglobin in Type 1 and Type 2 Diabetes

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  • YOSHIUCHI Kazutomi
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • MATSUHISA Munehide
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • KATAKAMI Naoto
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • NAKATANI Yoshihisa
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • SAKAMOTO Kenya
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • MATSUOKA Takaaki
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • UMAYAHARA Yutaka
    Department of Internal Medicine, Osaka Police Hospital
  • KOSUGI Keisuke
    Department of Internal Medicine, Osaka Police Hospital
  • KANETO Hideaki
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • YAMASAKI Yoshimitsu
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
  • HORI Masatsugu
    Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine

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Abstract

To determine the impact of blood glucose profile, involving fluctuation and excursion of blood glucose levels, on glycated proteins, we evaluated the association among the daily profile of blood glucose, and glycated albumin (GA) and HbA1c levels in patients with type 1 diabetes (n = 93) and type 2 diabetes (n = 75). GA levels were strongly correlated with HbA1c levels in type 1 (r = 0.85, P<0.0001) and type 2 diabetes (r = 0.61, P<0.0001), respectively. HbA1c levels were similar between patients with type 1 and type 2 diabetes, while GA levels were significantly higher in type 1 diabetes. Thus the ratio of GA levels to HbA1c levels was significantly higher in type 1 diabetes than that in type 2 diabetes (3.32 0.36 vs. 2.89 0.44, p<0.001). The degrees of GA levels and HbA1c levels correlated with maximum and mean blood glucose levels in patients with type 1 and type 2 diabetes. Stepwise multivariate analysis revealed that GA levels independently correlated with maximum blood glucose levels in type 1 diabetes (F = 43.34, P<0.001) and type 2 diabetes (F = 41.57, P<0.001). HbA1c levels also independently correlated with maximum blood glucose levels in type 1 diabetes (F = 34.78, P<0.001), as well as being correlated with mean blood glucose levels in type 2 diabetes (F = 11.28, P<0.001). In summary, GA could be a better marker for glycemic control than glycated hemoglobin in diabetic patients, especially for evaluating glycemic excursion, which is considered to be a major cause of diabetic angiopathy.<br>

Journal

  • Endocrine Journal

    Endocrine Journal 55 (3), 503-507, 2008

    The Japan Endocrine Society

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