Beyond HbA1c and glucose: the role of nontraditional glycemic markers in diabetes diagnosis, prognosis, and management
Open accessAbstract
Fasting glucose and hemoglobin A1c (HbA1c) are the standard measures for diagnosis and monitoring of diabetes. There has been recent interest in nontraditional markers of hyperglycemia, including fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG), as alternatives or adjuncts to standard measures. There is a growing literature linking these nontraditional markers with microvascular and macrovascular complications. Fructosamine and glycated albumin have also been shown to improve identification of persons with diabetes. However, long-term prospective studies with clinical outcomes are lacking. Some modern laboratory assays for fructosamine, glycated albumin, and 1,5-AG have excellent performance. Expanded use of these tests has the potential to improve diabetes care as these measures may overcome limitations of HbA1c in certain patients, complement traditional measures by providing additional information on shorter-term glycemic control, and improve risk stratification for diabetes and its complications. Nonetheless, studies are needed to demonstrate if their routine use will benefit patients and improve outcomes.
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Fructosamine and glycated albumin have been linked to long-term complications in epidemiologic cohort studies.
“Fructosamine and glycated albumin have been linked to long-term complications in epidemiologic cohort studies (14)(15)(16)(17)(18).”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [14]
Serum glycated protein assays (fructosamine and glycated albumin) may also be useful for glycemic monitoring in conjunction with other measures.
“Serum gly- cated protein assays (fructosamine and glycated albumin) may also be useful for glycemic monitoring in conjunction with other measures (see Section 6, “Glycemic Goals and Hypoglycemia”) (56)(57)(58)(59)(60).”
From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [56]
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References 113 · Cited by 154
Research works printed but not linked: 1
- [59]Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (update) London 2008 21678628
- Authors
- Parrinello, C. M., & Selvin, E.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Selvin, Elizabeth
- Venue
- Current Diabetes Reports
- Published
- 2014-09-24
- Volume
- 14
- Issue
- 11
- Pages
- 548-548
- ISSN
- 1534-4827 (ISSN-L)
- 1539-0829
- PMC
- PMC4214073
- OpenAlex
- W1985342881
- Cited by
- 154
- References
- 113
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 9 · 2023: 14 · 2022: 17 · 2021: 14 · 2020: 18 · 2019: 9 · 2018: 18 · 2017: 11 · 2016: 12 · 2015: 15
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Diabetes Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007024)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089174)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- fructosamine, glycated albumin, 1,5-anhydroglucitol, HbA1c, fasting blood glucose, diabetes diagnosis, diabetes prognosis, diabetes management, microvascular complications, macrovascular complications, risk stratification, glycemic control
- MeSH terms
- Glycated Serum Albumin, Blood Glucose, Cross-Sectional Studies, Deoxyglucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Fasting, Glycated Hemoglobin, Humans, Hyperglycemia, Prognosis, Prospective Studies, Serum Albumin, Biomarkers, Glycation End Products, Advanced, Fructosamine
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