Glycosylated serum proteins and glycosylated hemoglobin in the assessment of glycemic control in insulin-dependent and non-insulin-dependent diabetes mellitus
Beisswenger, P.J.; Healy, J.C.; Shultz, E.K.
Metabolism, Clinical and Experimental 42(8): 989-992
1993
ISSN/ISBN: 0026-0495
PMID: 8345823
DOI: 10.1016/0026-0495(93)90011-c
Accession: 008741548
To evaluate the relative value of glycosylated serum proteins (GSPs) versus glycosylated hemoglobin (HbA-1c) in assessing glycemic control in diabetes mellitus, we Performed regular monitoring of GSPs and HbA-1c in 30 subjects with insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) who performed frequent self-glucose monitoring. Analysis of the relationship between patterns of glycemic control and GSPs and HbA-1c demonstrated that subjects with IDDM and NIDDM appeared similar when the more traditional indicators of glycemic control such as mean blood glucose level (166.9 +- 20.9 v 177.4 +- 39.6 mg/dL) or HbA-1c (83.57 +- 12.8 v 80.24 +- 15.7 mmol hydroxymethyl furfuraldehyde (HMF)/mol hemoglobin (Hgb)) were used. However, when GSP levels or the standard deviation of mean glucose levels (SDMG) were used to assess glycemic control, higher levels were found in subjects with IDDM (52 +- 10.3 mg/g protein and 28.59 +- 7.60 mg/dL) versus NIDDM (44.6 +- 15.2 mg/g protein and 21.6 +- 15.9 mg/dL). Using multivariate analysis, GSPs were predictive of SDMG (P = .046), whereas HbA-1c added no significant further information (P = .27). Our results suggest that GSPs may be more sensitive than HbA-1c assay to the greater fluctuations in blood glucose levels generally associated with IDDM.