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Abstract
The measure of HbA1c is the gold standard index of glycemic control in clinical practice for diabetes treatment and is well known as a risk marker for diabetes complications. However, HbA1C does not accurately reflect glucose fluctuations or the actual status of glycemic control for several days or weeks. HbA1c measurement can be confounded in the anemia, hemoglobinopathy, or renal impairment. In comparison, glycated albumin (GA), a ketoamine formed by binding of albumin and glucose, more accurately reflects short-term changes in plasma glucose and postprandial plasma hyperglycemia (PPH). GA is not affected by hemoglobin or dialysis. 1,5-Anhydroglucitol (1,5-AG), another glycemic marker, structurally resembles glucose and decreases with spikes of hyperglycemia exceeding the average renal threshold for glucose. Especially, 1,5-AG level is reflective of PPH or glycemic variability and becomes an increasingly important contributor in a moderately controlled glycemic state, even when HbA1c level is within the target range. Herein, the usefulness of and recent studies on GA and 1,5-AG are summarized. Further investigations about the associations between these glycemic markers and diabetes complications are needed.
Figures and Tables
Fig. 1
Recommended algorithm of 1,5-anhydroglucitol (1,5-AG) in the decision of diabetes treatment.
Adapted from Duncan. Expert Rev Mol Diagn 2008;8:9-19 [15].
Table 2
Clinical conditions when measurement of glycated albumin are considered
Adapted from Koga M, et al. Endocrine J 2010;57:751-62 [14].
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