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

Evidence for consistency of the glycation gap in diabetes.

Author information

  • 1Wolverhampton Diabetes Centre, New Cross Hospital, Wolverhampton, UK. ananth.nayak@nhs.net

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.

PMID:
21715524
[PubMed - indexed for MEDLINE]
PMCID:
PMC3142043
Free PMC Article
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