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. 2011 Aug;34(8):1712-6.
doi: 10.2337/dc10-1767. Epub 2011 Jun 29.

Evidence for consistency of the glycation gap in diabetes

Ananth U Nayak  1 , Martin R Holland, David R Macdonald, Alan Nevill, Baldev M Singh
Affiliations

Evidence for consistency of the glycation gap in diabetes

Ananth U Nayak et al. Diabetes Care. 2011 Aug.

Abstract

Objective: Discordance between HbA(1c) and fructosamine estimations in the assessment of glycemia is often encountered. A number of mechanisms might explain such discordance, but whether it is consistent is uncertain. This study aims to coanalyze paired glycosylated hemoglobin (HbA(1c))-fructosamine estimations by using fructosamine to determine a predicted HbA(1c), to calculate a glycation gap (G-gap) and to determine whether the G-gap is consistent over time.

Research design and methods: We included 2,263 individuals with diabetes who had at least two paired HbA(1c)-fructosamine estimations that were separated by 10 ± 8 months. Of these, 1,217 individuals had a third pair. The G-gap was calculated as G-gap = HbA(1c) minus the standardized fructosamine-derived HbA(1c) equivalent (FHbA(1c)). The hypothesis that the G-gap would remain consistent in individuals over time was tested.

Results: The G-gaps were similar in the first, second, and third paired samples (0.0 ± 1.2, 0.0 ± 1.3, and 0.0 ± 1.3, respectively). Despite significant changes in the HbA(1c) and fructosamine, the G-gap did not differ in absolute or relative terms and showed no significant within-subject variability. The direction of the G-gap remained consistent.

Conclusions: The G-gap appears consistent over time; thus, by inference any key underlying mechanisms are likely to be consistent. G-gap calculation may be a method of exploring and evaluating any such underlying mechanisms.

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Figures

Figure 1
Figure 1
Scatter diagrams plotting the G-gap for the first HbA1c-fructosamine pair against product of two G-gaps (first vs. second, top, and second vs. third, bottom).
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References

    1. Macdonald DR, Hanson AM, Holland MR, Singh BM. Clinical impact of variability in HbA1c as assessed by simultaneously measuring fructosamine and use of error grid analysis. Ann Clin Biochem 2008;45:421–425 - PubMed
    1. Hempe JM, Gomez R, McCarter RJ, Jr, Chalew SA. High and low hemoglobin glycation phenotypes in type 1 diabetes: a challenge for interpretation of glycemic control. J Diabetes Complications 2002;16:313–320 - PubMed
    1. Yudkin JS, Forrest RD, Jackson CA, Ryle AJ, Davie S, Gould BJ. Unexplained variability of glycated haemoglobin in non-diabetic subjects not related to glycaemia. Diabetologia 1990;33:208–215 - PubMed
    1. Jeffcoate SL. Diabetes control and complications: the role of glycated haemoglobin, 25 years on. Diabet Med 2004;21:657–665 - PubMed
    1. Kilpatrick ES. Problems in the assessment of glycaemic control in diabetes mellitus. Diabet Med 1997;14:819–831 - PubMed

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