Fructosamine as an index of glycaemia of type 2 diabetes mellitus patients at Jos University Teaching Hospital

Abstract

Introduction: With increasing prevalence of DM worldwide and imported lifestyle changes in our environment, there is a compelling need for adequate treatment and improved/novel monitoring tools.Fructosamine therefore may be useful as a complementary or substitute monitoring index given that is cheaper, technically easier to perform than HbA and the assays have now been standardized and 1c automated. This study aimed to determine the serum fructosamine concentration and the albumin adjusted fructosamine in type 2 diabetes mellitus patient as a measure of monitoring plasma glucose.
Methods: A cross-sectional study involving 180 study participants. A structured questionnaire was administered. The analysis was done using SPSS. Descriptive and inferential statistics were used with p < 0.05 considered statistically significant. Ethical clearance and informed consent were obtained before the commencement of the study. Participants were T2DM patients of JUTH aged 18-65 years while controls were healthy non-diabetic consenting staff of JUTH/clinical students of University of Jos. Samples collected were assayed for HbA1c, fasting glucose, Fructosamine and albumin.
Results: A hundred and twenty T2DM and 60 controls participated in the study. There were more females (87) than males (33) T2DM patients. The mean Fasting Blood Glucose (FBG), Fructosamine, HbA1c and Albumin amongst patients was 9.4±4.9 mmol/L, 392.5±137.1 μmol/L, 8.6±2.7% and 48.0±5.4 g/L compared to controls of 4.8±0.5 mmol/L, 258.7±21.0 μmol/L, 5.6±0.5 % and 50.9±2.6 g/L respectively. The differences in the mean FBG, fructosamine and HbA levels among patients and controls was IC statistically significant (P<0.001). Adjusted fructosamine using three different formulae showed higher adjusted fructosamine in patients than in controls (P<0.001). Serum Albumin however was significantly higher in controls than patients with a p-value of less than 0.001.
Conclusion: This study has shown that serum fructosamine correlate significantly with the FBG among T2DM patients and even revealed a slightly better correlation than HbA and can therefore be used to 1c monitor blood glucose level among T2DM patients requiring a shorter period of follow-up and with financial constraints.