Is HbA1c the only choice? Alternative biomarkers for glycaemic control assessment

A rise in concentrations of glycated proteins occurs in diabetic patients; glycated hemoglobin is the most significant parameter, a ‘gold standard’ for glycaemic control. Other serum proteins also become glycated, i.a albumins and immunoglobulins. In practice, Fructosamine and glycated albumin are used. However, some conditions influence HbA1c concentrations, hence the search for alternative biomarkers for glycaemia monitoring. Glycated albumin (GA) appears to be the most promising, as its assessment enables both faster detection of changes in glycaemia control in cases of poor metabolic discipline and documentation of glyceamic control improvement, after appropriate treatment is implemented. This may be important mostly in patients scheduled for surgical, cardiosurgical or orthopedic procedures, which are sometimes postponed because of inadequate glycaemia control. Monitoring GA in particular groups of patients (i.a during pregnancy, with renal insufficiency or haematologic comorbidities) reflects glycaemic control levels more accurately than HbA1c