Impaired fasting glucose (IFG), impaired blood sugar after oral glucose tolerance test (OGTT), impaired glucose tolerance (IGT), glycated hemoglobin (HbA1c) between 5.7 and 6.4% (39-46 mmol/mol) are parts of “Prediabetes” clinical condition. Several clinical studies have repeatedly pointed out that subjects with prediabetes have an increased risk of developing cardiovascular disease compared to normoglycemic subjects.
From these considerations, it is evident the importance of carrying out an early diagnosis of prediabetes in order to implement targeted strategies to prevent the development of diabetes and cardiovascular diseases.
FRUCTOSAMINE AND GLYCATED ALBUMIN
Fructosamine and glycated albumin are molecules formed from the binding of sugars with serum proteins (largely Albumin) in conditions of chronic hyperglycemia or relevant hyperglycemic peaks, through the glycosylation process. The term fructosamine indicates all the glycated proteins present in the plasma, obviously including the glycated albumin, its largest component. The dosage of fructosamine is less expensive and easier to perform than HbA1c and measures the total glycated proteins and the percentage of glycated albumin in the serum. Albumin and fructosamine are short-term indicators of glucose homeostasis, providing information on blood glucose levels over the previous 2-4 weeks.
Glycated albumin is formed by post-translational non-enzymatic reaction between albumin and glucose, and its measurement reflects the average of glycemia of the last 2-3 weeks prior to blood sample. Glycated albumin, unlike glycated hemoglobin, can be measured on serum or plasma even in patients with anemias, hemoglobinopathies or with kidney failure, as an alternative to glycated hemoglobin which can not be used in these particular situations.
GA: MEDIUM-TERM GLYCEMIC MARKER
Compared to HbA1c which is a long-term glycemic indicator (about 120 days), GA is a medium-term glycemic indicator, reflecting the average life of albumin (approximately 20 days). Compared to HbA1c, this means that GA may indicate early both an improvement and a worsening of a patient’s blood glucose compensation. It is therefore useful in all those conditions that require a short-term control of blood glucose changes, for example after starting or changing a therapy.
GA should also be considered as a predictor of risks in case of diabetes type 1 and 2, and also during pregnancy.
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