Clinical usefulness of serum fructosamine and HbA1 as markers for metabolic control in patients with changing insulin regimens.

The therapy of 10 patients with insulin-dependent diabetes mellitus was changed from insulin twice a day to the use of insulin pens four times a day. The possible changes in glycaemic control were monitored by day curves once a week and analysis of fructosamine and glycated haemoglobin once a fortnight. No significant changes in these parameters were seen. However, a significant decrease in the number of hypoglycaemic periods does point to an improvement of therapy. One patient having elevated values of glucose and glycated haemoglobin but "normal" concentrations of fructosamine prompted us to analyze in detail the influence of protein and albumin on fructosamine. Correction of fructosamine for low protein or albumin increases the value of this test.