Usefulness of Estimation of Glycated Albumin and Glycosylated Haemoglobin in Indian Diabetic Chronic Kidney Disease Patients

Glycosylated hemoglobin (HbAlc) is most often used as an intermediate indicator for blood glucose control in diabetics, and the Diabetes Control and Complications Trial (DCCT) [1], United Kingdom Prospective Diabetes Study (UKPDS) [2] and Kumamoto Study [3] have greatly valued HbAlc as an indicator for blood glucose control. However, HbAlc levels are influenced by other factors in addition to blood glucose. Of these other factors, the life span of erythrocytes is particularly important. The HbA 1c assay provides falsely low readings in diabetic patients with end-stage renal disease (ESRD) [4–6]. This phenomenon likely relates to the shortened red blood cell survival observed in ESRD, with reduced time available for glucose and hemoglobin to chemically interact [7]. In contrast, the glycated albumin (GA) assay appears to more accurately reflect recent glycemic control in diabetic patients with ESRD who are on dialysis [4–6]. The GA assay mainly reflects serum glucose control over the preceding 17-day period (maximum 60 days), relative to the HbA1c assay which predominantly reflects glycemic control over the preceding 30 days (maximum 120 days).