Fructosamine in non-diabetic first degree relatives of type 2 diabetes patients: Risk assessor

Introduction: A positive family history of diabetes increases the chances of developing the disease manifold. The earliest diagnostic marker for diabetes is elevated plasma glucose levels. Glycosylated haemoglobin (HbA1c) gives information on the long term control of diabetes, while the estimation of fructosamine (FA) depicts the short term glycaemic control. The specificity of the estimation of fructosamine and its comparison with the established markers in a group with high risk for the disease was the purport. Methods: 23 non-diabetic first degree relatives of type 2 diabetics (Group 2) were compared with 20 healthy controls (Group 1) and 23 type 2 diabetic people (Group 3). Fasting plasma glucose (FPG), glycosylated haemoglobin (HbA1c), serum fructosamine and total proteins (TP) were estimated in fasting blood samples. The saliva was analyzed for fasting salivary glucose (SG), salivary fructosamine and total proteins. The body mass index (BMI), waist circumference (WC) and the blood pressure were recorded and compared. Results: Group 3 had significantly higher mean FPG (150.26mg/dl), HbA1c (8.23 %) and salivary FA (202.05 mg/dl) values. Group 2 was associated with elevated serum FA levels (533.62 mg/dl), increased serum FA/ total protein (TP) ratio and a larger WC. On correlation analysis, FPG correlated significantly and positively with HbA1c in all three groups and with WC and BMI (0.613 and 0.400 respectively) in Group 2 only. Conclusion: Serum FA foretells the development of diabetes in high risk populations, but it has less sensitivity in depicting chronic hyperglycaemia. Serum FA and WC could be useful predictors of the development of diabetes in 'high risk' individuals.