Diabetes markers can determine risk independently of glucose levels

Diabetes risk can be determined using three novel biomarkers which provide information independently of single glucose and HbA1c measures, US researchers have found.

Dr Elizabeth Selvin and colleagues from the John Hopkins School of Medicine in Maryland looked at the link between diabetes risk and levels of fructosamine, glycated albumin and 1,5-anhydroglucitol.

Dr Selvin and her team said these biomarkers could help diagnose diabetes when measures of glucose or HbA1 are not available. The additional tests could also help improve identification of people with diabetes, especially since single measures of glucose or HbA1c in individuals tend to vary over time.

The researchers measured levels of the biomarkers in 1,299 people enrolled in an atherosclerosis risk study. Previous studies have looked at the levels of these biomarkers in people already diagnosed with diabetes, but not those who may be at risk of the disease.

Over the course of three years, 119 new cases of diabetes developed in this group. The researchers found that, compared the quarter of participants who had the highest levels of fructosamine and glycated albumin with the quarter of participants who had the lowest levels.

Those with the highest levels of fructosamine had a four-fold greater risk of developing diabetes. Those with the highest levels of glycated albumin had a five-fold greater risk of diabetes. High levels of 1,5-anhydroglucitol were associated with a four-fold lower risk of developing diabetes.

Dr Selvin and her team found that these associations persisted even after adjustment for baseline HbA1c and fasting glucose levels. They believe this suggests ‘that these alternative markers of hyperglycaemia may contribute independent information regarding diabetes risk’.

The researchers also found that both fructosamine and glycated albumin ‘provided additional prognostic information regarding diabetes risk above and beyond baseline HbA1c’.

They concluded: ‘Our results suggest that elevations in these measures of short-term hyperglycaemia may be useful indicators of a future diabetes risk, independently of single baseline fasting glucose and HbA1c measurements in persons without a previous diagnosis of diabetes.’

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