COMPARISON OF SERUM FRUCTOSAMINE VS GLYCOHEMOGLOBIN AS MEASURES OF GLYCEMIC CONTROL IN A LARGE DIABETIC POPULATION

In diabetic patients, measurement of glycohemoglobin (HbA(1c)) is wide ly accepted as the standard method for determining long-term glycemic control. Another test, the serum fructosamine test, has been suggested as a less costly alternative. To compare these two tests, we evaluate d how well each correlated with fasting blood glucose and how well eac h could predict the degree of glycemic control perceived by treating p hysicians. Among 222 diabetic subjects, fructosamine (r=0.74) and fruc tosamine corrected for serum albumin (c-fructosamine) (r=0.79) correla ted better with fasting blood glucose than did HbA(1c) (r=0.68) (P<0.0 5). Among 450 diabetic subjects, fructosamine, c-fructosamine, and HbA (1c) showed similar error rates (23%-26%) when discriminating between subjects who had either poor vs not-poor control or poor-to-fair versu s good-to-excellent control. However, receiver operating characteristi c curves for these tests indicated that HbA(1c) was the best discrimin ator because it showed a 9% to 10% greater area under the curve (P<0.0 5).