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Fructosamine Test for Diabetes When The A1C May Not Be Accurate | Diabetes Daily Post
Fructosamine Test for Diabetes When The A1C May Not Be Accurate

Fructosamine Test for Diabetes When The A1C May Not Be Accurate

anemiaHemoglobin A1C (A1C) is a test commonly used to diagnose and manage diabetes. This test may be altered in patients with anemia. The body has red blood cells and inside these red blood cells is a protein called hemoglobin. Hemoglobin is responsible for carrying oxygen throughout the body. Glucose (sugar) in the blood attaches to hemoglobin. The more sugar in a person’s blood, the more will be attached to hemoglobin. The A1C test measures how much sugar is attached to hemoglobin over the past three months and provides a picture of average blood sugar levels over that period of time. Many different types of anemia exist, but it is basically when someone does not have enough healthy red blood cells. There are many different causes of anemia such as poor nutrition, chronic diseases such as chronic kidney disease, blood loss, low iron levels, inherited traits such as sickle cell disease, and many more. Because the A1C test uses hemoglobin to determine average blood glucose, any condition that can affect red blood cells and hemoglobin, such as anemia, can alter A1C test results.

If it is suspected that anemia is impacting your A1C results, a fructosamine test may be ordered. The American Diabetes Association (ADA) recommends the use of the fructosamine test in patients with any condition that affects the lifespan of red blood cells, such as anemia. Fructosamine is formed from sugar in the blood attaching to a protein in the blood called albumin and some other blood proteins as well. Unlike hemoglobin, albumin and these other blood proteins that form fructosamine are not affected by anemia because they are not part of red blood cells. Just like the A1C test, the more sugar in the blood the more sugar will attach to albumin and other blood proteins to form fructosamine. Unlike the A1C test, the fructosamine test measures average blood sugar levels over the past three weeks rather than the past three months. This is because albumin has a shorter life span than hemoglobin.

The normal fructosamine range is 200-285 umol/L. Fructosamine values can be compared to A1C values by using a specific equation. A fructosamine value of 317, 375, and 435 are comparable to an A1C value of 7%, 8%, and 9% respectively. If you are a patient with both diabetes and anemia, and suspect your A1C may be inaccurate, discuss getting a fructosamine test done rather than an A1C test with your provider.

This article is brought to you by our guest writers:
Kayla Natali, PharmD candidate 2016
Damian Bialonczyk, PharmD, MBA, Medical Affairs Fellow, Becton Dickinson, MCPHS University
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, Professor of Pharmacy Practice, School of Pharmacy-Boston, MCPHS University, Boston, MA, Clinical Pharmacist, Well Life Medical, Peabody, MA

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