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

We studied the cross-sectional relationship between GA and HbA I c in 142 type 2 diabetic patients who had an HbA1c level <7.5% for at least one year without fluctuation by more than 0.5%. We also followed the changes of GA and HbA I c in 18 type 2 diabetic patients for 16 weeks as they progressed from untreated severe hyperglycemia (HbA1c >= 9.0%) to good glycemic control (HbA1c <= 6.5%) by intensive insulin treatment. The annual mean levels of GA and HbA I c in the stably controlled patients showed a weak, but significant, correlation (r = 0.23, p<0.00 1) in the 142 diabetic patients. However, the GA/HbA1c ratio ranged widely from 2.0 to 4.0 showing a normal distribution (2.9 +/- 0.34, M +/- SE), although patients with conditions affecting albumin turnover or RBC lifespan were excluded from the study. The GA/HbA1c ratio was significantly higher when patients were in hyperglycemic than when glycemic control was good (3.5 +/- 0.15vs.2.9 +/- 0.07,M +/- SE,p<0.01). GA decreased more rapidly than HbA1c during intensive insulin therapy, but the percent reduction of HbA I c eventually corresponded with that of GA by 16 weeks after the start of treatment. These results demonstrate that, although unknown influences on GA or HbA1c may exist, GA may be a useful marker for monitoring short-term variations of glycemic control during treatment of diabetic patients.