LONGITUDINAL CHANGES IN SERUM FRUCTOSAMINE DO NOT PARALLEL THOSE IN GLYCATED HEMOGLOBIN IN YOUNG-ADULTS WITH INSULIN-DEPENDENT DIABETES

In 93 adolescent and young adult patients with type 1 diabetes (163 paired comparisons) changes in fructosamine concentration correlated poorly with changes in HbA1 (r = 0.53); this correlation was no better if fructosamine values were adjusted for serum albumin by calculating a fructosamine/albumin index, F.A.I. (155 pairs, r = 0.50). These correlation coefficients were lower than those for cross-sectional comparisons (HbA1 vs. fructosamine, r = 0.74; HbA1 vs. F.A.I., r = 0.80). One-way analysis of variance showed that values of HbA1, fructosamine and F.A.I. all tended to increase as glycaemic control, judged by the clinician, worsened (P < 0.001). HbA1 correlated better with clinical assessment than did either uncorrected fructosamine or F.A.I. We conclude that changes in fructosamine from one clinic visit to the next do not provide a basis for changing therapy. Clinical assessments tend to agree with values for HbA1, which may be more reliable than fructosamine because of its longer biological half life. © 1990.