by Glycated albumin, an alternative indicator of glycemic control
Glycated albumin, also known as glycated serum protein or glycated albumin (GA), is a form of human serum albumin that is non-enzymatically glycated as a result of exposure to glucose in the bloodstream. When blood glucose levels are elevated, as seen in diabetes, more glucose will bind to albumin in a non-enzymatic reaction known as glycation. The level of glycated albumin corresponds to the blood glucose levels over the previous 2-3 weeks and provides a measure of short-term glycemic control.
Why measure Glycated Albumin Assay levels?
While hemoglobin A1c (HbA1c) is the gold standard test used to monitor long-term blood sugar control in patients with diabetes, it does have some limitations. HbA1c reflects average blood glucose levels over the past 2-3 months. It is not as effective in assessing glycemic control in certain patient populations such as those with anemia, abnormalities of red blood cell turnover, or hemoglobinopathies.
Glycated Albumin Assay has emerged as an alternative marker that can complement or potentially replace HbA1c in certain situations. Because albumin has a shorter half-life than hemoglobin, measuring glycated albumin levels provides a way to assess glycemic control over a period of approximately 2-3 weeks. This makes it useful for:
– Patients with fluctuating blood glucose levels: Glycated albumin may help identify post-prandial hyperglycemia or glycemic variability that is not detected by HbA1c.
– Patients undergoing rapid changes in glycemic control: It more promptly reflects changes made to diet, medication regimen or insulin therapy and helps assess treatment success.
– Patients who are pregnant: HbA1c levels may be falsely lowered during pregnancy due to increased red blood cell turnover. Glycated albumin is not affected.
– Patients receiving blood transfusions or experiencing other conditions affecting red blood cell lifespan.
Relationship between glycated albumin and complications
Several studies have found glycated albumin to have a stronger correlation with diabetic complications compared to HbA1c. For example, higher levels of glycated albumin have been linked to increased risk of:
– Retinopathy: A large longitudinal study showed glycated albumin had a stronger association with development and progression of diabetic retinopathy than HbA1c.
– Nephropathy: High glycated albumin independently predicts development and progression of diabetic kidney disease even after adjusting for HbA1c and other risk factors.
– Neuropathy: Elevated glycated albumin has been correlated with increased severity of diabetic peripheral neuropathy.
– Cardiovascular disease: Both cross-sectional and prospective cohort studies report an independent association between higher glycated albumin and cardiovascular events in people with diabetes.
How is Glycated Albumin Assay measured?
Glycated Albumin Assay Laboratory tests for glycated albumin use enzyme-linked immunosorbent assay (ELISA) techniques to measure the concentration of glycated albumin in blood samples. The normal reference range is less than 16-18% depending on the lab method used. Glycated albumin reflects glycemic control over approximately 2-3 weeks and should be interpreted together with other diabetes management markers such as HbA1c, blood glucose self-monitoring results, medical history and symptoms.
Potential applications of glycated albumin testing
While more research is still needed, glycated albumin is showing promise as a useful addition to the diabetes monitoring toolbox. It may help optimize management in patients where HbA1c results are unreliable or do not provide the full story. Some potential clinical applications of glycated albumin testing include:
– Monitoring short-term glycemic control in patients with rapidly changing blood glucose levels. This includes during pregnancy, illness or initiation of new treatments.
– Detecting post-meal hyperglycemia, often missed by HbA1c but an important target for reducing complications.
– Guiding insulin regimen adjustments, such as prandial insulin dose changes in response to post-meal spikes.
– Identifying poor adherence to recommended medical nutrition therapy or medication plans.
– Assessing treatment response sooner than HbA1c, allowing more prompt intervention if glycemic targets are not being met.
– Monitoring patients receiving blood transfusions or with other conditions affecting red blood cell lifespan.
– Potentially reducing healthcare costs by detecting diabetic control issues earlier before the development of serious complications.
while HbA1c remains the gold standard indicator of long-term glycemic control, glycated albumin provides additional short-term information about diabetes management that may help optimize care. It especially benefits those with fluctuating blood glucose levels or conditions where HbA1c results cannot be reliably interpreted. As testing methods become more widely available, glycated albumin could become a valuable complement to HbA1c in achieving long-term health outcomes for people living with diabetes
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
