Clinical use: Clinician measure fructosamine to assess intermediate – term glycemic control
Background: Fructosamine is a general term, which applies to any glycated protein. It is formed by the nonenzymatic reaction of glucose with the a- and e-amino groups of proteins to form intermediate compounds called aldimines. These aldimines may dissociate or undergo an Amadori rearrangement to form stable ketoamines called fructosamines. This non – enzymatic glycation of specific proteins in vivo is proportional to the prevailing glucose concentration during the lifetime of the protein.

Glycated protein measurements in the diabetic patient are felt to be a better monitor of long-term glycemic control than individual or sporadic glucose determinations. Usually glycated haemoglobin (HbA1c) which reflects glucose control over the previous 6 – 8 weeks is used in this context. However, serum fructosamine which indicates average blood glucose concentrations over a 2-3 week period is a necessary alternative when use of HbA1c is contra-indicated, abnormalities of red blood cell aging, haemolytic anaemia and haemoglobinopathy (sickle cell disease) and also when it is required to measure glycaemic control during a rapid change in patient treatment.

Note that a falsely low fructosamine may be encountered with conditions leading to decreased blood total protein and/or albumin.

Reference ranges:
Associated diseases:
Patient preparation: None
Specimen requirements: Serum – SST
Turnaround time: 1 week
Time limit for retrospective requesting: N/A
Additional information: www.labtestsonline.org.uk
Referred test: Referred test
Location: New Cross Hospital