Fructosamine as an Indicator for Glycemic Control in the Veteran Community.

Area of Science:

• Endocrinology and Metabolism
• Clinical Chemistry

Background:

• Hemoglobin A1c (HbA1c) monitoring is inaccurate in patients with hemoglobinopathies or erythrocyte disorders.
• Fructosamine offers a shorter detection period (2-3 weeks) compared to HbA1c (3-4 months).
• Veterans have a higher prevalence of hemoglobinopathies, necessitating alternative glycemic monitoring methods.

Purpose of the Study:

• To evaluate the correlation between HbA1c and fructosamine assays in the veteran population.
• To determine if fructosamine can serve as a viable alternative for glycemic control assessment in veterans at Veterans Affairs facilities.

Main Methods:

• Retrospective chart review of 156 veterans from December 2007 to December 2018.
• Inclusion criteria: veterans >18 years with simultaneous HbA1c and fructosamine assays.
• Exclusion criteria: hemoglobinopathies, erythrocyte disorders, or serum protein altering pathologies; linear regression and paired t-test analysis.

Main Results:

• A strong correlation (coefficient of 0.75, P < 0.05) was found between HbA1c and fructosamine.
• The regression equation determined was HbA1c (%) = 0.0154 * Fructosamine (mmol/L) + 3.121.
• Paired t-test showed no significant difference between measured HbA1c and predicted HbA1c from fructosamine values.

Conclusions:

• Fructosamine is a strong and reliable alternative for assessing glycemic control in veterans, particularly those with hemoglobinopathies.
• Physicians at Veterans Affairs can utilize fructosamine for stringent glycemic monitoring in specific patient groups.
• Further data is needed before fructosamine can completely replace HbA1c for all glycemic monitoring.