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Glycated albumin ‘good predictor’ when assessing glucose management
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When assessing glycemic management in diabetes, measuring glycated albumin may be a more effective tool than measuring HbA1c, particularly among patients with a recent diabetes diagnosis, according to findings published in the Journal of Diabetes and its Complications.
“When adjusting treatment in patients with newly diagnosed diabetes, we do not need to consider other factors such as BMI or baseline C-peptide,” Linong Ji, MD, a professor in the department of endocrinology at Peking University People's Hospital in Beijing, and Qian Ren, MD, an associated professor in the department of endocrinology at Peking University People's Hospital in Beijing, told Endocrine Today. “Focusing on glycated albumin decline is enough. So in patients with newly diagnosed diabetes, we provide a simple strategy in therapy adjustment.”
Ji, Ren and colleagues analyzed data from 499 adults with type 2 diabetes (mean age, 54.8 years; 54.3% women), including 176 adults who had a recent type 2 diabetes diagnosis and 323 adults who had been taking an oral diabetes drugs, such as metformin or a sulfonylurea, and were unable to reach an HbA1c below 7%. At baseline and at 91 days, the researchers measured weight, height, HbA1c, glycated albumin, fasting blood glucose, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, C-peptide, aspartate transaminase, glutamic-pyruvic transaminase, blood urea nitrogen and serum creatinine. In addition, at 14 and 28 days, the researchers measured HbA1c and glycated albumin.
Among those with a recent diabetes diagnosis, 66.9% had HbA1c less than 7% at the study’s conclusion, whereas 34.8% of those who were using an oral diabetes drug at study onset met this threshold (P < .001). The researchers also found that 81.1% of those with a recent diabetes diagnosis experienced a 0.5% or greater HbA1c decrease vs. 61.4% of those using an oral diabetes drug at study onset (P < .001). In addition, participants with a recent diabetes diagnosis averaged a 1.3% HbA1c decrease, whereas those already taking oral diabetes drugs averaged a 0.7% HbA1c decrease (P < .001). Participants with a recent diabetes diagnosis averaged a 3.4% glycated albumin decrease compared with a 2% decrease among those already taking oral diabetes drugs (P < .001).
Good glycemic control was effectively predicted by glycated albumin at 28 days in those with a recent diabetes diagnosis (OR = 1.63; 95% CI, 1.3-2.044) and those who had been taking oral diabetes drugs (OR = 1.478; 95% CI, 1.284-1.702), the researchers wrote. In addition, good glycemic control was effectively predicted by C-peptide index, baseline HbA1c, diabetes duration and BMI in patients who used oral diabetes drugs at study onset.
“It is of great importance to precisely predict future glycemic control when prescribing drugs for patients. Currently, all the guidelines suggest using HbA1c for adjusting treatment based on a great deal of previous research about HbA1c,” the researchers wrote. “Glycated albumin decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside glycated albumin decline, other individualized clinical characteristics should also be considered.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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