Prediction of near-future glycated hemoglobin levels using glycated albumin levels before and after treatment for diabetes

Abstract

Aims/Introduction: In the present study, whether near-future glycated hemoglobin (A1C) levels could be predicted by changes in glycated albumin (GA) levels before and after treatment for diabetes was investigated.

Materials and methods: After starting diabetes treatment, GA and A1C levels are assumed to change exponentially. From this assumption, the equation for predicting near-future GA and A1C levels was derived. A total of 54 patients with type 2 diabetes mellitus in whom diabetes treatment was initiated or altered were enrolled. By incorporating GA and A1C values before and 2-4 weeks after starting treatment (second visit) into the equation, the predicted GA and A1C levels at the third visit (5-7 weeks after treatment) were obtained.

Results: A strong and positive correlation was observed between predicted GA and measured GA at the third visit (R = 0.669, P < 0.0001). Similarly, a strong and positive correlation was observed between the predicted A1C and the measured A1C at the third visit (R = 0.795, P < 0.0001).

Conclusions: GA and A1C levels 1-3 months after starting diabetes treatment could be predicted using the equation developed. The prediction of near-future A1C levels using GA levels at two points would be useful for judging the effectiveness of ongoing diabetes treatment at an earlier stage. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00107.x, 2011).

Keywords: Glycated albumin; Glycated hemoglobin; Glycemic control.

Figure 1

Correlations between (a) predicted and measured glycated albumin (GA), and (b) predicted and measured glycated hemoglobin (A1C) at the third visit. Using the equations with GA and A1C before the start of treatment (first visit), and GA and A1C at the time of the second outpatient visit (second visit), the predicted GA and A1C values at the third visit were calculated, and their correlations with the measured GA and A1C values were investigated. The broken line corresponds to y = x.

Figure 2

Relationships between predicted and measured (a) glycated albumin (GA) and (b) glycated hemoglobin (A1C) values (a patient in whom glycemic control worsened during sulfonylurea treatment and insulin was started in the hospital).