[Fructosamine and HbA1c during monitoring of glucose levels in diabetes].

The authors compared the nycthemeral variations of fructosamine levels in nineteen patients with diabetes to fluctuations in their glucose levels. Thirty-five other patients with poorly controlled diabetes were given an optimal treatment then followed up for 2 months (mean glucose levels, fructosamine and HbA1c assays). Mean nycthemeral variations in fructosamine levels did not appear to be correlated with glucose levels. However, intraindividual nycthemeral variability was greater than the analytic variability. After correction for total protein levels this variability was smaller but remained significative. In this longitudinal study, fructosamine and HbA1c levels decreased when control of glucose levels improved. However, decreases were notably greater in HbA1c than in fructosamine compared at 15, 45 and 60 days of follow up. Inversely, fructosamine was correlated better with the mean glucose levels of the preceding 7 days than was HbA1c. When mean glucose levels were calculated for the 15, 30, 45 and 60 preceding days, the results favored HbA1c. The findings presented in this study show that HbA1c remains the best criteria for monitoring medium term glucose levels. However, further word is needed before this conclusion can be confirmed.