Fructosamine is a compound which can be considered as the result of a reaction between fructose and ammonia or an amine (with a molecule of water being released). Fructose (also levulose or laevulose) is a simple reducing Sugar ( Monosaccharide) found in many foods and is one of the three Ammonia is a compound with the formula N[[hydrogen H3]] It is normally encountered as a Gas with a characteristic pungent Odor Amines are Organic compounds and Functional groups that contain a basic Nitrogen Atom with a Lone pair. A fructosamine is also formed when carbonyl group of glucose reacts with an amino group of a protein, as the double bond to oxygen moves from the end carbon atom to the next carbon atom and water is released. In Organic chemistry, a carbonyl group is a Functional group composed of a Carbon Atom double-bonded to an Oxygen Glucose (Glc a Monosaccharide (or simple Sugar) also known as grape sugar, is an important Carbohydrate in Biology. Amines are Organic compounds and Functional groups that contain a basic Nitrogen Atom with a Lone pair. Fructosamines formed from blood proteins such as serum albumin are known as Glycated Serum Protein (GSP) or Glycated Albumin, and are used to identify the plasma glucose concentration over time and so assess diabetic control. Serum albumin, often referred to simply as albumin, is the most abundant Plasma protein in humans and other Mammals Albumin is essential for maintaining Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended Glucose (Glc a Monosaccharide (or simple Sugar) also known as grape sugar, is an important Carbohydrate in Biology. In Chemistry, concentration is the measure of how much of a given substance there is mixed with another substance Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc [1]
| Diabetes mellitus
|
|---|
| Types of Diabetes |
| Diabetes mellitus type 1 Diabetes mellitus type 2 Gestational diabetes Pre-diabetes: |
| Disease Management |
| Diabetes management: •Diabetic diet •Anti-diabetic drugs •Conventional insulinotherapy •Intensive insulinotherapy |
| Other Concerns |
| Cardiovascular disease
Diabetic comas: Diabetic myonecrosis |
| Blood tests |
| Blood sugar Fructosamine Glucose tolerance test Glycosylated hemoglobin |
Contents |
Indications
More commonly diabetics have their glucose control assessed with the Glycosylated hemoglobin measurement that assesses average glucose levels over the preceding 6 weeks; as reflected by the permanent glycosylation of a small fraction of the hemoglobin molecules in their blood. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Diabetes mellitus type 1 (Type 1 diabetes Type I diabetes T1D T1DM IDDM juvenile diabetes is a form of Diabetes mellitus. Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non - Insulin -dependent Diabetes mellitus (NIDDM or adult-onset diabetes is a metabolic Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood Impaired fasting glycaemia (IFG is a pre-diabetic state of dysglycemia associated with insulin resistance and increased risk of cardiovascular pathology although of lesser risk than Impaired Glucose Tolerance (IGT is a pre- Diabetic state of dysglycemia that is associated with Insulin resistance and increased risk of cardiovascular pathology Diabetes is a Chronic disease with no cure As of 2008. It is associated with an impaired Glucose cycle, altering Metabolism. The diet most often recommended for people who suffer from Diabetes mellitus is high in Dietary fiber, especially soluble fiber but low in fat (especially Saturated fat Anti-diabetic drugs treat Diabetes mellitus by lowering Glucose levels in the blood Conventional insulinotherapy is a therapeutic regimen for treatment of Diabetes mellitus which contrasts with the newer Intensive insulinotherapy. Intensive insulinotherapy is a therapeutic regimen for Diabetes mellitus treatment Cardiovascular disease or cardiovascular diseases refers to the class of diseases that involve the Heart or Blood vessels ( arteries and Diabetic coma is a Medical emergency in which a person with Diabetes mellitus is Comatose (unconscious because of one of the acute complications Diabetic hypoglycemia describes a low blood glucose level occurring in a person with Diabetes mellitus. Diabetic ketoacidosis (DKA is a life-threatening complication in patients with diabetes mellitus Nonketotic hyperosmolar coma (nonketotic Hyperglycaemia) is a type of Diabetic coma associated with a high mortality seen in Diabetes mellitus type 2. Diabetic myonecrosis is a rare complication of Diabetes. It is caused by Infarcted Muscle tissue usually in the thigh Diabetic nephropathy ( nephropatia diabetica) also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive Kidney Diabetic neuropathies are neuropathic disorders that are associated with Diabetes mellitus. Diabetic retinopathy is Retinopathy (damage to the Retina) caused by complications of Diabetes mellitus, which can eventually lead to Blindness For women with Diabetes mellitus, Pregnancy can present some particular challenges for both mother and child Blood sugar, used in a physiological context is a misnomer and misleading A glucose tolerance test in medical practice is the administration of Glucose to determine how quickly it is cleared from the blood Glycosylated (or glycated hemoglobin ( hemoglobin A1c Hb1c, or HbA1c) is a form of Hemoglobin used primarily to identify the average Glycosylated (or glycated hemoglobin ( hemoglobin A1c Hb1c, or HbA1c) is a form of Hemoglobin used primarily to identify the average Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein However, this is not appropriate where there has been a recent change in diet or treatment within 6 weeks, nor if there are abnormalities of red blood cell aging process or mix of hemoglobin subtypes (predominantly HbA in normal adults). Hence people with recent blood loss or hemolytic anemia, or hemoglobinopathy such as sickle-cell disease are not suitable for some glycosylated hemoglobin methods that do not account for higher-turnover hemoglobin. Hemolytic anemia is Anemia due to Hemolysis, the abnormal breakdown of Red blood cells (RBCs either in the Blood vessels (intravascular hemolysis Hemoglobinopathy is a kind of Genetic defect that results in abnormal structure of one of the Globin chains of the Hemoglobin molecule Sickle-cell disease or sickle-cell anaemia (or anemia) is a Blood disorder characterized by Red blood cells that assume an abnormal rigid Fructosamine is used in these circumstances, as it also reflects an average of blood glucose levels, but over a shorter period of 2 to 3 weeks. Fructosamine is also of use in conditions, such as pregnancy, in which hormonal changes cause greater short-term fluctuation in glucose concentrations. Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female
Interpretation of results
There is no standard reference range available for this test. The reference values depends upon the factors of patient age, gender, sample population and test method. Hence each laboratory reports will include their specific reference range for the test. An increase in fructosamine in lab testing results usually means an increase in glucose in the blood.
Approximately each change of 3. 3 mmol (60 mg/dl) in average blood sugar levels will give rise to changes of 2% HbA1c and 75 µmol fructosamine values. [2] However this over emphasises the upper limit of many laboratories' reference ranges of 285mmol/l as equivalent to HbA1c 7. 5% rather than 6. 5%. A comparative study,[3] which has been used in official advice for Quality and Outcomes Framework guidance in the UK[4] and summaried by the United States' National Quality Measures Clearinghouse:[5] gives the following formula and resulting values:
- Hence:
| Fructosamine (µmol) |
HbA1c % |
|---|---|
| 200 | 5 |
| 258 | 6 |
| 288 | 6. The Quality and Outcomes Framework (QOF is a system for payment of GPs in the UK National Health Service. 5 |
| 317 | 7 |
| 346 | 7. 5 |
| 375 | 8 |
| 435 | 9 |
| 494 | 10 |
| 552 | 11 |
| 611 | 12 |
See also
Footnotes
- ^ Delpierre G, Collard F, Fortpied J and Van Sschaftingen E (2002). Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc "Fructosamine 3-kinase is involved in an intracellular deglycation pathway in human erythrocytes" (PDF). Biochem. J. 365: 801–8.
- ^ Bartol T (December 1, 2000). Comparison of Blood Glucose, HbA1c, and Fructosamine. Retrieved on 2007-06-04. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 781 BC - The first historic Solar eclipse is recorded in China. - gives a comparison chart and cites following source:
- Nathan DM, Singer DE, Hurxthal K, Goodson JD (1984). "The clinical information value of the glycosylated hemoglobin assay". N. Engl. J. Med. 310 (6): 341–6. PMID 6690962.
- ^ Cohen RM, Holmes YR, Chenier TC, Joiner CH (2003). "Discordance between HbA1c and fructosamine: evidence for a glycosylation gap and its relation to diabetic nephropathy". Diabetes Care 26 (1): 163–7. PMID 12502674.
- ^ "Diabetes (DM) Indicator 20 The percentage of patients with diabetes in whom the last HbA1c is 7. 5 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months", Quality and outcomes framework Guidance 2006 (PDF), BMA, 39. Retrieved on 2008-01-02. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 366 - The Alamanni cross the frozen Rhine River in large numbers invading the Roman Empire.
- ^ Diabetes mellitus: the percentage of patients with diabetes in whom the last HbA1c is 7.5 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months. National Quality Measures Clearinghouse (12/31/2007). Retrieved on 2008-01-02. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 366 - The Alamanni cross the frozen Rhine River in large numbers invading the Roman Empire.
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