What is the purpose of a fructosamine (glycated albumin) blood test?

From the Guidelines

The fructosamine blood test is a valuable tool for monitoring short-term glycemic control in diabetic patients, particularly in situations where the A1C test may not be suitable, as evidenced by the most recent study in 2024 1.

Key Points About Fructosamine Testing

• The test measures the average blood glucose levels over the past 2-3 weeks, providing a more immediate picture of recent glucose management compared to the HbA1c test.
• Fructosamine is particularly useful for patients with conditions affecting red blood cell lifespan, such as hemolytic anemia or recent blood loss, as well as pregnant women who require closer monitoring.
• The test complements HbA1c monitoring by offering a different timeframe perspective on glucose control, which can help guide more timely treatment decisions.
• Normal fructosamine levels typically range from 200-285 μmol/L, with higher values indicating poorer glucose control.

Clinical Application of Fructosamine Testing

• The test can be used to monitor the effectiveness of treatment changes and to identify patients who may require more frequent monitoring or adjustments to their diabetes management plan.
• Fructosamine testing can also be used in conjunction with self-monitoring of blood glucose and continuous glucose monitoring to provide a more comprehensive picture of glycemic control.
• As noted in the 2024 study, fructosamine and glycated albumin have been linked to long-term complications in epidemiologic cohort studies, although more clinical trials are needed to fully establish their role in monitoring glycemic status 1.

Important Considerations

• The performance of modern fructosamine assays is typically excellent, and the test is highly correlated with glycated albumin in people with diabetes.
• However, the evidence base supporting the use of fructosamine to monitor glycemic status is weaker than that for A1C, and more research is needed to fully establish its clinical utility.
• Despite these limitations, the fructosamine blood test remains a useful tool for monitoring short-term glycemic control in diabetic patients, particularly in situations where the A1C test may not be suitable 1.

From the Research

Fructosamine Blood Test

• The fructosamine blood test is used to measure the average blood glucose levels over the past 2-3 weeks 2, 3.
• It is an alternative to the HbA1c test, which measures average blood glucose levels over the past 2-3 months 4, 3.
• Fructosamine is unaffected by disorders of red blood cells, making it a useful test for patients with conditions such as hemolytic anemia or sickle cell disease 4, 5.

Advantages of Fructosamine Test

• The fructosamine test can provide a more accurate picture of blood glucose control in patients with red blood cell disorders or those who have recently received blood transfusions 4, 5.
• It can also reflect shorter-term changes in glycemia, making it a useful tool for monitoring patients who have recently changed their diabetes treatment plan 4, 2.

Correlation with HbA1c and Blood Glucose Levels

• Studies have shown that fructosamine levels correlate with HbA1c and blood glucose levels, although the strength of the correlation can vary depending on the population being studied and the time frame being considered 2, 3, 6.
• In general, fructosamine levels tend to correlate more strongly with blood glucose levels over the past 2-3 weeks, while HbA1c levels correlate more strongly with blood glucose levels over the past 2-3 months 3.

Clinical Usefulness

• The fructosamine test can be a useful adjunct to the HbA1c test in certain clinical situations, such as in patients with red blood cell disorders or those who have recently received blood transfusions 4, 5.
• It can also be useful in patients who have difficulty monitoring their blood glucose levels at home, as it can provide a more accurate picture of their blood glucose control over the past 2-3 weeks 2.