Fructosamine test and diabetes

Managing diabetes through blood sugar monitoring is very important to limit complications of the disease. The Fructosamine test helps monitor the effectiveness of diabetes treatments after several weeks of medication or insulin.

Fructosamine, also known as cetoamine, is made by glycosylation of proteins with glucose. This is the name for iso glucosamine - a derivative of the product of the non-enzymatic reaction between sugars (mainly glucose) and proteins (mainly albumin). Albumin and proteins bind to glucose to form glycates, including GSA (glycated serum albumin) and GSP (glycated serum protein).
Blood proteins, especially albumin, can react with glucose or other monosaccharides, forming a variety of products. When the glucose concentration remains elevated continuously, glucose molecules tend to bind permanently to hemoglobin (Hb) and to the structures of serum proteins by non-enzymatic glycosylation (also called glycation).
Glycolysis of plasma albumin and protein is increased in diabetic patients. Since albumin has a half-life of 2 to 3 weeks, a quantitative fructosamine assay is used to assess the patient's mean blood glucose status over the previous 2 to 3 weeks. The concentration of fructosamine in the blood depends on the concentration of glucose in the blood plasma. When blood sugar is high continuously and for a long time, it will cause protein glycosylation to increase fructosamine levels, helping to identify and diagnose diabetes through testing the amount of glycosylated protein.
MORE: How do I know if I should get tested for diabetes?

There are currently two indirect parameters that measure the average blood glucose level in patients with diabetes. They are:
Glycosylated hemoglobin (HbA1C): This is a test that provides an average glucose value over the previous 120 days based on the binding of glucose to the hemoglobin of red blood cells. HbA1c for the average glucose level of the previous 2 - 3 months; Fructosamine: Shows average glucose levels for 10 - 20 days prior to blood collection. Both tests are used to control blood sugar in people with diabetes. Among them, HbA1c is more widely used. However, fructosamine is more useful in identifying acute 1 - 3 week metabolic changes. The Fructosamine test is useful for short-term glycemic control and helps to assess the effectiveness of diabetes treatment. The higher the mean glycemic value, the higher the fructosamine. In particular, fructosamine is high in diabetic patients who are not treated with appropriate hypoglycemic therapy.
The Fructosamine test is influenced by many external factors and should not be used as a screening test for diabetes or for patients with well-controlled diabetes. However, this test may be useful for those who cannot measure HbA1c accurately. Specifically, the Fructosamine test is indicated to monitor blood sugar levels for the following cases:
Patients are in intensive care, helping to quickly assess the treatment of hyperglycemia (within within a short period of time). 3 weeks) from which to make timely adjustments if necessary. Fructosamine allows evaluation of the effect of diet or changes in diabetes treatment after 3 weeks; Women with gestational diabetes: Measuring fructosamine helps monitor and regulate changes in the use of glucose, insulin or other drugs; Presence of an acute or systemic illness that may alter glucose and insulin requirements for some time; The presence of some hemoglobin variants such as HbF, HbE,... can affect the method of measuring HbA1c; When the value of HbA1c is incorrect in the case of patients with sickle cell anemia, hemolytic anemia, frequent blood transfusions, ...

The doctor may order a Fructosamine test to:
Closely monitor the average glucose levels over the past 1-3 weeks in a patient with diabetes; Evaluation of treatment response to insulin therapy; Developing or modifying diabetes care, observing response; Monitor fructosamine levels in patients with gestational diabetes to adjust treatment to keep levels stable.

Implementation personnel: 1 university staff, 1 technician majoring in biochemistry; Means: Test machine Hitachi 717, 912, Modular P,...; Chemicals: Fructosamine reagent, Fructosamine quality control agent, Fructosamine standard; Patient: A detailed explanation of the purpose of the blood collection is given; Test sheet: Specify the name, age, gender, department, diagnosis and test indication.

Sample collection:
Take 3ml of venous blood into a tube that does not contain anticoagulant or contains anticoagulants such as Heparin, EDTA, to ensure that the blood does not burst red blood cells; After taking blood, centrifuge to separate plasma or serum; Specimens are stable for 3 days at 20 - 25°C, 2 weeks at 2–8°C, 2 months at -20°C; Specimens are thawed only once and must be left at room temperature before analysis. To avoid evaporation, specimens, quality control agents and standards should be analyzed within 2 hours; Technical procedure:
Prepare the analyzer to perform sample analysis: The instrument is installed with the Fructosamine test program, which has been calibrated with the Fructosamine test. Fructosamine test results are satisfactory, not out of range, and do not violate the law on quality control; The person performing the sample analysis enters the patient information data and assigns the test to the analyzer or the network system, if any; Load patient samples into the machine; Set up the machine to analyze patient samples; Wait for the machine to analyze the patient sample according to its protocol; When the results are available, it is necessary to review and evaluate the results, print the report or record the results on the test sheet, and return it to the patient.

Normal value: 205 - 285 μmol/L; Increased value: In patients with poorly controlled diabetes causing high blood sugar levels in the previous 1-3 weeks. In addition, people with hyperthyroidism and using vitamin C also have higher than normal results; Reduced value: Seen in cases with conditions leading to a decrease in albumin levels such as renal failure, nephrosis, acute hepatitis, chronic hepatitis, thyroid dysfunction, pregnancy, conditions leading to dehydration (fever) high fever, diarrhea, severe burns, ...). Fructosamine test is indicated to evaluate the effectiveness of short-term treatment of diabetes and cases such as gestational diabetes, sickle cell anemia and hemoglobinopathy, etc. For the most accurate results, patients should choose reputable medical facilities with good expertise to perform.
Vinmec International General Hospital is the address for examination, treatment and effective monitoring of many diseases. At Vinmec, there is a system of modern facilities, international standard testing machines, a team of experienced and qualified medical professionals capable of examining, taking samples, samples and taking steps. Testing according to the correct procedure should give accurate results. Help the doctor have the opportunity to diagnose the disease condition and advise on the use of drugs, lifestyle maintenance, nutrition to minimize the complications caused by diabetes.