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Diabetes Treatment Information - Tests The FructosamineTest What is fructosamine? Fructosamine is a protein that attaches to glucose in the bloodstream. If a patient’s fructosamine is elevated, then the patient's average glucose level over the previous 2 to 3 weeks has also been elevated. What is a fructosamine test? Studies, including The Diabetes Control and Complications Trial (DCCT, show that keeping your HbA1c at or below 7% (7.0 on the test scale) is associated with a dramatic reduction in risk for developing long-term diabetes complications. Other studies that address amputation (the need for amputation, and surgical outcome) clearly show that HbA1c results have a strong impact on a patients outcome post-surgery. HbA1c levels also have a direct impact on how well chronic infections heal, and whether or not gangrene will result. But an HbA1c test is not the only test that may be used to measure overall glycemic control in persons with diabetes. Sometimes, an alternative test, the fructosamine test, may be used to complement, or substitute for the HbA1c when an HbA1c may not be accurate or moer rapid information about glucose control is needed. This fructosamine test has been used since the 1980s. Unlike the HbA1c test which measures glucose control over the previous 120 days, the fructosamine test is a measure of blood glucose (blood sugar) control during the previous 2-3 weeks. The fructosamine test can be beneficial for women with diabetes that become pregnant, or for those that have changes in their care plan, or a medical condition that requires closer monitoring of overall blood glucose control. Although the HbA1c test is more commonly used today, the American Diabetes Association (ADA) recognizes both tests as being a useful tool in monitoring diabetes control. The ADA has stated that fructosamine testing may be useful in persons where an HbA1c test may not produce reliable results. How is the test performed? The fructosamine test is a simple blood test that measures glycated protein (a protein that has bonded with a glucose molecule). Because it measures the average glucose over the previous 2-3 weeks the test is not affected by food you may eat during the day of the test. Therefore, there is no need to perform a fasting fructosamine test; it can be done at any time during the day. What does the test show? The test measure the precensce of fructosamine. Generally, the concentration of fructosamine, the higher the average blood glucose (sugar) level. Trends are as important as absolute values when using the fructosamine test as a measure of overall glycemic control. For example, a trend from normal to high may be an indication of poor blood glucose control. And the reverse is true, that, a trend from high to normal, may indicate that there is good bllod glucose control. Fructosamine tests do not replace the need to daily blood glucose (sugar) monitoring. The results of frustosamine testing need to be compared with a patient's daily diabetes log because certain things can affect test results. Islets of Hope Health Tip: Remember, your doctor needs the information from your daily diabetes log to compare with the results of your fructosamine test. When daily slef blood glucose monitoring (SBGM) data conflicts with the results of a fructosamine test, your doctor may want to investigate further to see if there are other underlying medical concerns that have affected your fructosamine results. See more detail below under "When might fructosamine test results not be accurate?" What are normal values for a fructosamine test?
Fructosamine Test Levels and Glucose Control
Who might benefit from having a fructosamine test? Fructosamine tests may be useful when:
Islets of Hope Health Tip: Although a fructosamine test can be a useful tool for some persons with diabetes, fructosamine concentrations of well-controlled diabetics can be the same as with those of non-diabetics (both may show a "normal" value of fructosamine levels). For this reason the fructosamine test is not useful as a screening test for diabetes and those newly diagnosed diagnosed with diabetes should have an HbA1c test done instead. Things that may have an effect on test results
When might a fructosamine test not be accurate? Fructosamine results should be considered a part of the overall context of the patient’s total clinical findings and not as an abolute determination for how well a patient is managing their diabetes. That is, results should be compared with daily blood glucose (sugar) monitoring, and other health information. False, low fructosamine results may be seen with decreased protein levels or increased protein loss, or, when there is a change in the type of protein produced by the body. Also, just as can be true with the HbA1c test, persons whose blood glucose levels erratically fluctate from high to low (brittle diabetes) may appear to have near normal, or even normal levels, of fructosamine, when in fact their glucose control is not adequate. If a patient's fructosamine test results conflict with self blood glucose monitoring (SBGM), the fructosamine test might not be an accurate reflection of overall blood glucose control. For example, if a person has many SBGM readings in the 100-120 range but a high fructosamine level of 400, the two do not reconcile. Your doctor can check for reasons why your fructosamine is lower or higher than your SBGM readings indicate. He/she may with to do a complete blood count (CBC) test (see side bar for more information), or check for other medical problems like hyperthryoidism (elevated thyroid levels) or liver disease. As with an HbA1c, certain things can falsley lower or elevate results of a fructosamine test. Fructosamine results and may be falsely lowered by:
Conversely, the following can cause a fructosmine test to yield falsely higher results:
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