Serum fructosamine and glycated haemoglobin measurements in diabetic control.

Serum fructosamine and glycated haemoglobin (HbA1) were measured in capillary samples from diabetic children and compared with samples from non-diabetic children. Glycaemic control was assessed clinically and by average daily glucose values recorded by home monitoring. Fructosamine correlated with HbA1 and with average glucose values measured over 30 days. HbA1 also correlated with average glucose values measured over 60 days. Changes in fructosamine with time tended to parallel those of HbA1, and advance indication of deteriorating or improving glycaemic control was possible by observing changes in these. Fructosamine has many advantages over HbA1 measurement such as speed, technical ease, and low cost, and is a reliable alternative to HbA1 estimation as an indication of glycaemic control.

The diagnostic value of glycated haemoglobin levels in post-mortem blood.

Glycated haemoglobin (HbA1) in post mortem blood was estimated following electrophoretic separation. HbA1 was measured in preserved and unpreserved specimens and its stability in vitro was studied. No significant change in the proportion of HbA1 was observed in samples stored for more than 40 days at 4 degrees C. Specimens were analysed for glucose and HbA1. There was poor correlation between these parameters, and no significant difference between the mean values of HbA1 in specimens collected within 24, 48 and 72 or more hours following death, from subjects with no previous history of diabetes. The levels were within the laboratory reference range, whilst eight specimens collected from diabetic subjects demonstrated elevated levels. There was no significant difference in HbA1 levels collected from different sites in the body even though the glucose levels showed some variation. The measurement and apparent stability of HbA1 post mortem may be a more useful diagnostic test than glucose alone where diabetes may be suspected.

The estimation of serum fructosamine: an alternative measurement to glycated haemoglobin.

A method is presented for the estimation of fructosamine using a Cobas Bio centrifugal analyser. The effect of three different preparations of human serum albumin used for construction of calibration curves of 1-deoxy-1-morpholinofructose is described. The selection of serum albumin and the concentration used in the standard solutions is critical since the dose-response curve is affected differently and will therefore influence the estimated values. Normal ranges were obtained for non-diabetic subjects with normal protein status and for a group of females with reduced albumin levels due to pregnancy or oestrogen therapy. There was no significant difference between fructosamine levels in these populations. Fructosamine was also estimated in 250 patients attending a diabetic out-patient department and this correlated well with haemoglobin A1 estimated simultaneously. The method is rapid, technically simple and inexpensive and may prove to be a useful and reliable alternative to HbA1 estimation.