The Role of Serum Fructosamine as a Screening Test for Gestational Diabetes Mellitus

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Abstract
The serum fructosamine concentration indicates the degree of glycation of serum proteins, particularly albumin, and reflects an average blood glucose level over the previous 1-3 weeks. Serum fructosamine, glycated haemoglobin (HbA1c), total serum protein, serum albumin, fasting plasma glucose and oral glucose tolerance test (OGTT) have been measured in 127 healthy control subjects, 102 type 1 and 152 type 2 diabetes mellitus patients and 106 nondiabetic pregnant women. Fructosamine concentration of 2.24 ± 0.16 and 3.21 ± 0.41 mmol/l (mean ± S.D.) has been found in control subjects and diabetics respectively (P < 0.001). During the second trimester a significantly lower fructosamine level (1.92 ± 0.21 mmol/l) has been found in pregnant women, most likely due to the low serum albumin concentration (31.35 ± 3.97 g/l). None of them had a fructosamine level above the normal limit of 2.55 mmol/l. On the other hand, 12 pregnant women showed a disturbed OGTT with normal fructosamine. If the serum fructosamine concentration was adjusted for 40 g/l albumin, then a mean fructosamine of 2.16 ± 0.24 mmol/l was found in patients with gestational diabetes. Our results show that serum fructosamine has a similar diagnostic value as HbA1c for non-pregnant adults, but neither can replace OGTT for the diagnosis of gestational diabetes.

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