The Value of HbA1 and Fructosamine in Predicting Impaired Glucose Tolerance—An Alternative to OGTT to Detect Diabetes Mellitus or Gestational Diabetes

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Abstract
Glycosylated haemoglobin and glycosylated serum protein concentrations (fructosamine) have been monitored in patients suspected of diabetes mellitus ( n = 183), in pregnant women suspected of gestational diabetes ( n = 250) and in control groups ( n = 184). The response to the standard 75 g oral glucose tolerance test was used to confirm or reject the diagnosis, using different criteria for detection of diabetes mellitus compared to detection of gestational diabetes. A slightly higher sensitivity was observed for fructosamine compared to glycosylated haemoglobin to detect impaired glucose tolerance (52 vs 44%) or gestational diabetes (17% vs 8%). For detection of diabetic oral glucose tolerance no difference was observed between glycosylated haemoglobin and fructosamine; sensitivity for both parameters was 67%. The results suggest that fructosamine is slightly more sensitive in detecting borderline-abnormal glucose tolerance, whereas no differences are observed for detection of clearly abnormal oral glucose tolerance tests.