Glycated albumin as medium-term glycemic control in diabetes mellitus

Fahrun Nur Rosyid, Khristophorus Heri Nugroho Hario Seno, Ahmad Fadhlur Rahman


Monitoring of glucose levels is essential in preventing the complications of diabetes mellitus, including short, medium and long-term monitoring. Short-term monitoring includes random plasma glucose, fasting plasma glucose, 2-hour post prandial plasma glucose and Oral glucose tolerance tests (OGTT). The medium-term monitoring includes fructosamine and Glycated albumin (GA) while the long-term monitoring is glycated hemoglobin (HbA1c). Currently, the most recommended examination for glucose level monitoring in patients with diabetes mellitus is the glycated hemoglobin (HbA1c). However, there seem to be some conditions where the HbA1c value is doubtful or unreliable. Some of these conditions include anemia, thalassemia, dialysis and pregnancy. The best choice at this time is GA.


Diabetes mellitus, Glycated albumin, Glycemic status

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American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care. 2015;38:8-16.

Liu T, Gong J, Chen Y, Jiang S. Periodic vs constant high glucose in inducing pro-inflammatory cytokine expression in human coronary artery endothelial cells. Inflamm Res. 2013;62(7):697-701.

Qi WW, Zhong LY, Li XR, Li G, Liu ZX, Hu JF, et al. Hyperglycemia induces the variations of 11β-hydroxysteroid dehydrogenase type 1 and peroxisome proliferator-activated receptor-γ expression in hippocampus and hypothalamus of diabetic rats. Exp Diabetes Res. 2012;2012:107130.

Clayton W, Elasy TA. A review of the pathophysiology, classification, and treatment of foot ulcers in diabetic patients. Clin Diabetes. 2009;27(2):52-8.

Dinu IR, Moţa E. Glycated albumin - More than the missing link in the evaluation of diabetes control. Rom J Diabetes, Nutr Metab Dis. 2014;21(2):137-50.

Lee SY, Chen YC, Tsai IC, Yen CJ, Chueh SN, Chuang HF, et al. Glycosylated hemoglobin and albumin-corrected fructosamine are good indicators for glycemic control in peritoneal dialysis patients. PLoS One. 2013;8(3):57762.

Matsumoto H, Mishiba Y, Yamamoto N, Sugitatsu NS, Shibasaki S, Sano H, et al. Glycated albumin to glycated hemoglobin ratio is a sensitive indicator of blood glucose variability in patients with fulminant type 1 diabetes. Intern Med. 2012;51(11):1315-21.

Koga M, Kasayama S. Clinical impact of glycated albumin as another glycemic control marker. Endocr J. 2010;57(9):751-62.

Takahashi S, Uchino H, Shimizu T, Kanazawa A, Tamura Y, Sakai K, et al. Comparison of glycated albumin (GA) and glycated hemoglobin (HbA1c) in type 2 diabetic patients: usefulness of GA for evaluation of short-term changes in glycemic control. Endocr J. 2007;54(1):139-44.

Clark SL, Santin AE, Bryant PA, Holman R, Rodnick KJ. The initial noncovalent binding of glucose to human hemoglobin in nonenzymatic glycation. Glycobiology. 2013;23(11):1250-9.

Barlovic DP, Paavonen A, Dahm KA. RAGE biology, atherosclerosis and diabetes. Clin Sci (Lond). 2011;121(2):43-55.

Furusyo N, Hayashi J. Glycated albumin and diabetes mellitus. Biochim Biophys Acta. 2013;1830(12):5509-14.

Kosecki SM, Rodgers PT, Adams MB. Glycemic monitoring in diabetics with sickle cell plus beta-thalassemia hemoglobinopathy. Ann Pharmacother. 2005;39(9):1557-60.

Suwa T, Ohta A, Matsui T, Koganei R, Kato H, Kawata T, et al. Relationship between clinical markers of glycemia and glucose excursion evaluated by continuous glucose monitoring (CGM). Endocr J. 2010;57(2):135-40.

Kim KJ, Lee BW. The roles of glycated albumin as intermediate glycation index and pathogenic protein. Diabetes Metab J. 2012;36(2):98-107.

Roohk HV, Zaidi AR. A review of glycated albumin as an intermediate glycation index for controlling diabetes. J Diabetes Sci Technol. 2008;2(6):1114-21.

Evans TW. Review article: albumin as a drug--biological effects of albumin unrelated to oncotic pressure. Aliment Pharmacol Ther. 2002;16(5):6-11.

Arasteh A, Farahi S, Rezaei M, Movahedi AA. Glycated albumin: an overview of the In Vitro models of an In Vivo potential disease marker. J Diabetes Metab Disord. 2014;13:49.

Peacock TP, Shihabi ZK, Bleyer AJ, Dolbare EL, Byers JR, Knovich MA, et al. Comparison of glycated albumin and hemoglobin A(1c) levels in diabetic subjects on hemodialysis. Kidney Int. 2008;73(9):1062-8.

Hashimoto K, Osugi T, Noguchi S, Morimoto Y, Wasada K, Imai S, et al. A1C but not serum glycated albumin is elevated because of iron deficiency in late pregnancy in diabetic women. Diabetes Care. 2010;33(3):509-11.

Danese E, Montagnana M, Nouvenne A, Lippi G. Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes. J Diabetes Sci Technol. 2015;9(2):169-76.

Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care. 1999;22(6):920-4.

Soewondo P, Ferrario A, Tahapary DL. Challenges in diabetes management in Indonesia: a literature review. Global Health. 2013;9:63.

Yoshiuchi K, Matsuhisa M, Katakami N, Nakatani Y, Sakamoto K, Matsuoka T, et al. Glycated albumin is a better indicator for glucose excursion than glycated hemoglobin in type 1 and type 2 diabetes. Endocr J. 2008;55(3):503-7.

Nathan DM, McGee P, Steffes MW, Lachin JM. Relationship of Glycated Albumin to Blood Glucose and Glycated Hemoglobin (HbA). Published online. 2011:1-39.

Kohzuma T, Yamamoto T, Uematsu Y, Shihabi ZK, Freedman BI. Basic performance of an enzymatic method for glycated albumin and reference range determination. J Diabetes Sci Technol. 2011;5(6):1455-62.

Pu LJ, Lu L, Shen WF, Zhang Q, Zhang RY, Zhang JS, et al. Increased serum glycated albumin level is associated with the presence and severity of coronary artery disease in type 2 diabetic patients. Circ J. 2007;71(7):1067-73.

Edelman SV, Callahan P, Deeb LC. Multisite evaluation of a new diabetes self-test for glucose and glycated protein (Fructosamine). Diabetes Technol Ther. 2000;2(2):233-8.