Age-adjusted glycated albumin accurately reflects blood glucose in patients with neonatal diabetes mellitus: comparison with calculated glycated albumin determined by past blood glucose concentrations

Abstract

Background: Glycated albumin is a useful glycaemic control indicator for neonatal diabetes mellitus. However, glycated albumin concentrations in infants are lower than those in adults and increase in an age-dependent manner. Based on our investigation of non-diabetic subjects, we proposed the possibility that the reference range for adults may be used regardless of age, provided that age-adjusted glycated albumin is employed. In the present study, we evaluate the usefulness of age-adjusted glycated albumin in neonatal diabetes mellitus patients. Methods: Six neonatal diabetes mellitus patients (four patients with permanent neonatal diabetes mellitus and two patients with transient neonatal diabetes mellitus) were included. Measured glycated albumin or age-adjusted glycated albumin was compared to calculated glycated albumin, which was determined using calculation formulae we had reported based on past blood glucose over the 50 days before measurement of glycated albumin. Results: Measured glycated albumin was significantly lower than calculated glycated albumin (20.5 AE 4.9% versus 28.2 AE 6.1%; p < 0.0001), whereas age-adjusted glycated albumin was equivalent to calculated glycated albumin, showing no significant difference (27.5 AE 6.8% versus 28.2 AE 6.1%). Measured glycated albumin concentrations in patients with transient neonatal diabetes mellitus in remission were lower than the reference range for adults, whereas age-adjusted glycated albumin concentrations were within the reference range for adults. Conclusion: We demonstrated that age-adjusted glycated albumin concentrations were consistent with calculated glycated albumin. Age-adjusted glycated albumin is therefore a useful glycaemic control indicator for neonatal diabetes mellitus patients.

Age‐Adjusted Glycated Albumin at Diagnosis is more Correlated with the Product of Age and Plasma Glucose than Plasma Glucose Alone in Patients with Neonatal Diabetes Mellitus

“…Recently, we found that Aa-GA is a more accurate blood glucose indicator in patients with NDM based on the fact that mean blood glucose has strong positive correlation with Aa-GA (16). In this study, we obtained the new findings that Aa-GA at diagnosis in the patients with NDM is potentially affected by the age of diagnosis.…”

“…In addition, we reported that age-adjusted GA (Aa-GA) is applicable to all ages with the reference value for adults and that it is possible to evaluate glycemic control by using Aa-GA (15). Indeed, we showed that Aa-GA accurately reflects blood glucose in patients with NDM by comparing it with calculated glycated albumin determined by past blood glucose concentrations (16).…”

Glycemic control indicator levels at diagnosis of neonatal diabetes mellitus: Comparison with other types of insulin-dependent diabetes mellitus

“…The normal control HbA1c and GA levels are in the range of 4.6%‐6.2% and 11.0%‐16.0%, respectively. Age‐adjusted GA was calculated using the following formula that has been described in a previous report: …”

“…In an analysis of non‐diabetic subjects, there was a strong correlation between GA and log‐transformed age, from newborns to adults . We confirmed that age‐adjusted GA would accurately reflect glycemic control status in NDM …”

“…6 We confirmed that age-adjusted GA would accurately reflect glycemic control status in NDM. 7 Fulminant type 1 diabetes (FT1D), reported by Imagawa et al 8,9 , is a new subtype of type 1 diabetes. The pathologic feature of FT1D is the extremely rapid and almost complete destruction of pancreatic beta cells.…”