Evidence for consistency of the glycation gap in diabetes

Abstract

OBJECTIVE: Discordance between HbA(1c) and fructosamine estimations in the assessment of glycemia is often encountered. A number of mechanisms might explain such discordance, but whether it is consistent is uncertain. This study aims to coanalyze paired glycosylated hemoglobin (HbA(1c))-fructosamine estimations by using fructosamine to determine a predicted HbA(1c), to calculate a glycation gap (G-gap) and to determine whether the G-gap is consistent over time. RESEARCH DESIGN AND METHODS: We included 2,263 individuals with diabetes who had at least two paired HbA(1c)-fructosamine estimations that were separated by 10 ± 8 months. Of these, 1,217 individuals had a third pair. The G-gap was calculated as G-gap = HbA(1c) minus the standardized fructosamine-derived HbA(1c) equivalent (FHbA(1c)). The hypothesis that the G-gap would remain consistent in individuals over time was tested. RESULTS: The G-gaps were similar in the first, second, and third paired samples (0.0 ± 1.2, 0.0 ± 1.3, and 0.0 ± 1.3, respectively). Despite significant changes in the HbA(1c) and fructosamine, the G-gap did not differ in absolute or relative terms and showed no significant within-subject variability. The direction of the G-gap remained consistent. CONCLUSIONS: The G-gap appears consistent over time; thus, by inference any key underlying mechanisms are likely to be consistent. G-gap calculation may be a method of exploring and evaluating any such underlying mechanisms.

Citation

(2011). Evidence for consistency of the glycation gap in diabetes. Diabetes Care, 1712 -1716. https://doi.org/10.2337/dc10-1767

• Acceptance Date: Apr 24, 2011
• Publication Date: Aug 1, 2011
• Journal: Diabetes Care
• Print ISSN: 0149-5992
• Publisher: American Diabetes Association
• Pages: 1712 -1716
• DOI: https://doi.org/10.2337/dc10-1767
• Keywords: diabetes, fructosamine, hemoglobin A, glycosylated
• Publisher URL: http://dx.doi.org/10.2337/dc10-1767