Fructosamine as a Complementary Fasting Blood Sugar Test for Glycemic Control in Diabetic Patients on Hemodialysis

Objective: Diabetic patients with end-stage renal disease (ESRD) are more anemic and have low false hemoglobin A 1c (Hb A 1c ) levels. In diabetic mellitus (DM) patients undergoing hemodialysis (DM-HD), fructosamine or glycated serum proteins (GSP) circulate longer than hemoglobin (Hb) in blood and can act as better indicators for monitoring blood glucose at average levels. Materials and Methods: In a total of 57 patients (30/57 DM-HD patients and 27/57 DM patients without renal failure [DM-non HD]), Hb A 1c and fructosamine along with other serum parameters were measured. Hb A 1c was measured by ion-exchange chromatography, and fructosamine was measured by spectrophotometry. Results: Fructosamine mean in DM-HD and DM-non-HD patients was 494.25 ± 233.88 µmol/L and 398.34 ± 205.05 µmol/L respectively (P=0.0169). The Hb A 1c mean for the study groups was 7.88 ± 2.27% and 9.47 ± 2.51% (P=0.086). The fructosamine/Hb A 1c ratio in DM-HD patients was significantly higher than that in DM-non-HD patients (P=0.002). Conclusion: Fructosamine can be potentially considered as a complementary test along with fasting blood sugar to assess control of DM patients with ESRD.