value of fructosamine in monitoring diabetes control in NIDD with different stages of schistosomal liver disease

ABSTRACT

The value of fructosamine versus glycosylated hemoglobin HbA[1c] in monitoring diabetes control in diabetics with different stages of liver disease was investigated. The study included diabetics without liver disease [[Group I, n = 20], diabetics with compensated hepatosplenic schistosomiasis [HSS] [Group II, n = 20], diabetics with decompensated HSS [Group III, n 20]. Each group included patients who were controlled [n = 10] and others who were uncontrolled [n = 10] for at least 2 months before the stud. Group IV included 10 normal controls, 10 with compensated HSS and 10 with decompensated HSS without diabetes. Both HbA[1c] and fructosamine were determined by quantitative colorimetry. In diabetics without liver disease both fructosamine and HbA[1c] correlated significantly with plasma glucose was well as with each other and so fructosamine which is cheaper can be used alone for monitoring diabetes control in such cases. In the absence of diabetes fructosamine decreased in parallel with the progress of liver disease while HbA[1c] did not change. This illustrates the influence of decreasing albumin in fructosamine levels. Fructosamine was not correlated to HbA[1c] but was correlated to albumin. In diabetics with liver disease, fructosamine and HbA[1c] levels followed the same pattern as in patients without diabetes indicating that fructosamine levels are related more to albumin than the glucose levels. It can be concluded that fructosamine can be used safely for monitoring diabetes control in the absence of liver disease, while HbA[1c] is preferred with liver disease