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Fructosamine

Blood
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Report in 24Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Evaluate glucose levels in patients with conditions affecting hemoglobin (e.g., anemia, hemoglobinopathies) where HbA1c may be inaccurate

1,1991,455

18% OFF

Fructosamine Test Information Guide

  • Why is it done?
    • Measures short-term blood glucose control over the past 2-3 weeks by assessing glycated serum proteins, primarily albumin
    • Monitors glycemic control in patients with diabetes mellitus (Type 1 and Type 2) between HbA1c tests
    • Assesses glucose control in patients with hemoglobinopathies or conditions affecting red blood cell lifespan where HbA1c is unreliable
    • Evaluates glycemic control in patients with anemia or elevated hemoglobin F levels
    • Detects acute changes in blood glucose levels, particularly useful when rapid glucose control assessment is needed
    • Performed during routine diabetes follow-up appointments and when adjusting diabetes medications
  • Normal Range
    • Normal fructosamine levels: 200-285 μmol/L (or approximately 0.6-0.9 mmol/L depending on laboratory)
    • Reference ranges may vary slightly between laboratories; always refer to the specific laboratory's reference interval
    • Elevated levels (>285 μmol/L): Indicate suboptimal glucose control over the preceding 2-3 weeks
    • Low levels (<200 μmol/L): May indicate hypoglycemia or good glycemic control; however, very low values can be associated with liver disease or malnutrition
    • Units of measurement: Micromoles per liter (μmol/L) or millimoles per liter (mmol/L)
    • Normal results suggest adequate glucose control during the preceding 2-3 weeks; abnormal results indicate need for therapy adjustment
  • Interpretation
    • Elevated Fructosamine (>285 μmol/L): Suggests inadequate glucose control; indicates average blood glucose levels have been elevated over the past 2-3 weeks; may necessitate adjustments to diabetes medications, diet, or exercise regimen; correlates with increased risk of diabetic complications
    • Normal Fructosamine (200-285 μmol/L): Indicates good short-term glucose control; current diabetes management strategy is effective; routine monitoring should continue
    • Low Fructosamine (<200 μmol/L): May indicate excellent glucose control or episodes of hypoglycemia; excessively low levels warrant investigation for liver disease, malnutrition, or hypoalbuminemia; in patients on insulin, may suggest risk of hypoglycemic episodes
    • Factors Affecting Interpretation:
    • Hypoalbuminemia: Reduces absolute fructosamine levels; kidney disease, liver disease, or malnutrition can lower results
    • Hemolytic anemia: May cause falsely low readings due to decreased albumin turnover
    • Acute illness: Can transiently alter fructosamine levels independent of glucose control
    • Pregnancy: Increased albumin turnover may result in lower fructosamine levels; interpretation requires clinical context
    • Rapid changes in glucose: Reflects recent alterations in blood glucose patterns, making it superior to HbA1c for detecting acute control changes
  • Associated Organs
    • Primary Organ Systems Involved:
    • Pancreas: Abnormal fructosamine indicates impaired beta cell function and insulin secretion in diabetes mellitus
    • Liver: Produces albumin, the primary target for glycation; liver disease affects fructosamine interpretation
    • Kidneys: Dysfunction may be both a consequence of poor glycemic control and a factor affecting protein metabolism
    • Medical Conditions Associated with Abnormal Results:
    • Type 1 diabetes mellitus: Elevated fructosamine indicates insulin deficiency and poor glucose control
    • Type 2 diabetes mellitus: Elevated levels suggest insufficient glycemic control despite oral medications or lifestyle modifications
    • Gestational diabetes: Used to monitor glucose control during pregnancy
    • Chronic kidney disease: Affects both fructosamine levels and glucose metabolism
    • Liver cirrhosis: Causes low fructosamine due to reduced albumin synthesis
    • Hypoalbuminemia: From any cause reduces fructosamine measurements
    • Potential Complications from Poor Glucose Control:
    • Diabetic retinopathy: Progressive vision loss from hyperglycemia-induced retinal damage
    • Diabetic nephropathy: Kidney damage leading to proteinuria and chronic kidney disease
    • Diabetic neuropathy: Nerve damage causing pain, numbness, and functional impairment
    • Accelerated atherosclerosis: Increased cardiovascular and cerebrovascular disease risk
  • Follow-up Tests
    • Recommended Based on Elevated Fructosamine:
    • HbA1c (Glycated hemoglobin): Confirms long-term glucose control (8-12 weeks); provides complementary information to fructosamine
    • Fasting blood glucose: Assesses baseline glucose levels; helps identify nocturnal hypoglycemia or dawn phenomenon
    • Random blood glucose: Detects acute hyperglycemia and evaluates current glucose status
    • Continuous glucose monitoring (CGM): Provides real-time glucose trends and pattern identification
    • Serum albumin: Evaluate if low fructosamine suspected to be due to hypoalbuminemia rather than improved glucose control
    • Liver function tests: If low fructosamine; assesses hepatic albumin production capacity
    • Monitoring for Diabetic Complications:
    • Serum creatinine and estimated glomerular filtration rate (eGFR): Assess kidney function; detect diabetic nephropathy
    • Urine albumin-to-creatinine ratio (UACR): Detects early diabetic kidney disease
    • Lipid panel: Identifies dyslipidemia contributing to cardiovascular risk
    • Dilated eye examination: Screens for diabetic retinopathy
    • Monofilament testing: Detects diabetic peripheral neuropathy
    • Recommended Monitoring Frequency:
    • Fructosamine every 2-4 weeks: When initiating new diabetes therapy or making medication adjustments
    • Every 3 months: Routine monitoring in stable patients (coinciding with HbA1c testing)
    • As needed: During acute illness, pregnancy, or when rapid assessment of glucose trends is required
  • Fasting Required?
    • Fasting Required: No
    • Fructosamine measurement is not affected by recent food intake; blood can be drawn at any time of day without regard to meals
    • Special Instructions:
    • No special patient preparation required for fructosamine testing alone
    • If concurrent fasting blood glucose is ordered, patient must fast 8-10 hours prior (typically overnight fasting); nothing to eat or drink except water
    • Medications need not be held prior to fructosamine testing; continue all diabetes medications and other prescribed drugs as usual
    • Advise patient to maintain normal activity level and medication schedule on testing day
    • Patient may eat and drink normally before appointment if fructosamine is the only test ordered
    • Standard venipuncture precautions apply; blood collected in appropriate serum separator tube

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