An analysis of glycosylated blood proteins and blood glucose profiles over one year in patients with type 1 diabetes

The clinical value of prospective measurement of several direct and indirect measures of blood glucose control in the management of Type 1 diabetes has been investigated. Ninety-eight Type 1 diabetic patients were followed over a period of 1 year after a 6-week period of intensification of management, with monthly measurements of blood glucose profiles and 3-monthly HbA1, glycosylated serum albumin, and fructosamine measurements. All measures improved markedly after the initial 6-week period (p less than 0.001), and all except glycosylated serum albumin and fructosamine then remained relatively stable. Of fourteen serial comparisons, glycosylated blood proteins were significantly correlated more often with levels of mean blood glucose and M value (on 4-7 occasions, rs 0.30-0.58) than with fasting blood glucose levels (on only 2-3 occasions, rs 0.34-0.44). Serum fructosamine levels correlated significantly with mean blood glucose on four occasion (rs 0.30-0.50), whilst glycosylated serum albumin and HbA1 correlated with mean blood glucose on six occasions (rs 0.36-0.54). Glycosylated serum albumin correlated with HbA1 and fructosamine levels throughout the year (rs 0.47-0.68 and 0.48-0.76, respectively), but HbA1 and fructosamine were less clearly correlated with each other (rs 0.38-0.44), with no significant association immediately after the period of intensive management or 3 months later.(ABSTRACT TRUNCATED AT 250 WORDS)