Do glycoalbumin levels preferentially reflect changes in postprandial glucose excursions?

Diabet Med. 2017 Sep;34(9):1284-1290. doi: 10.1111/dme.13376. Epub 2017 Jun 13.


Aims: To evaluate whether plasma glycated albumin, which provides an integrated measure of plasma glucose levels over the preceding 2-4 weeks, better reflects changes in postprandial glucose excursions than HbA1c .

Methods: People with suboptimum glycaemic control on dual oral therapy were enrolled in the Treating-to-Target-in-Type 2 diabetes (4-T) trial, in which participants were randomized to the addition of once-daily basal insulin, twice-daily biphasic insulin or thrice-daily prandial insulin. Glycated albumin levels were assayed enzymatically from baseline and 1-year fasting plasma samples. We evaluated robust correlations of glycated albumin and HbA1c both with fasting and postprandial glucose levels at these two time points, and with insulin-induced changes in the postprandial excursion.

Results: Requisite data were available for 625 of the participants in the 4-T trial. Their mean (±sd) age was 62 ± 10 years and body weight was 85.8 ± 15.9 kg, and their median (interquartile range) diabetes duration was 9 (6, 13) years. Partial correlations at baseline and 1 year between postprandial glucose excursions and glycated albumin/HbA1c , after adjusting for fasting glucose, were 0.27/0.15 and 0.22/0.18, respectively. Glycated albumin, compared with HbA1c , explained 66% more of the variation in postprandial glucose excursions at baseline. At 1 year, postprandial glucose excursions on basal, biphasic and prandial and insulin therapy were reduced by 0.43, 0.78 and 1.88 mmol/l, respectively. These reductions were associated with changes in both glycated albumin and HbA1c (P < 0.01), with a stronger association for glycated albumin.

Conclusion: Changes in glycated albumin and HbA1c reflect changes in postprandial glucose excursions to a similar extent.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biphasic Insulins / administration & dosage
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Glycated Hemoglobin / drug effects
  • Glycated Hemoglobin / metabolism
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / diagnosis
  • Hyperglycemia / drug therapy
  • Insulin Detemir / administration & dosage
  • Male
  • Middle Aged
  • Postprandial Period* / drug effects
  • Serum Albumin / metabolism
  • Serum Albumin / physiology*


  • Biomarkers
  • Biphasic Insulins
  • Blood Glucose
  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • Serum Albumin
  • Insulin Detemir
  • Glycated Serum Albumin