A comparison of automated fructosamine and HbA(1c) methods for monitoring diabetes in pregnancy

Abstract

Two automated methods for measuring fructosamine (Test Plus and the original fructosamine assay) and glycated haemoglobin (Tina-quant immunoassay) were compared to determine which is the best index of blood glucose control during pregnancy. Thirteen women with type 1 diabetes were studied, with four-weekly measurements of HbA(1c) and fructosamine Test Plus using a Hitachi 911 analyser and fructosamine measured using an Olympus AU800 analyser. HbA(1c) correlated better (r = 0.573) with mean blood glucose (MBG) concentration than did fructosamine Test Plus (r = 0.347), even after correction for total protein concentration (r = 0.463), while there was no significant correlation with the original fructosamine method (r = 0.201). HbA(1c) correlated better with fasting/pre-prandial MBG concentrations, whereas fructosamine Test Plus correlated better with post-prandial MBG concentrations. Fructosamine Test Plus decreased with gestational age, and correlated with albumin and total protein concentrations, whereas HbA(1c) did not change with gestational age. Thus, HbA(1c) and fructosamine Test Plus were found to be useful in verifying home blood glucose measurements in diabetic pregnancy, with HbA(1c), being the best predictor of MBG concentration.