December 17, 2001
A1c (Glycohemoglobin, HgbA1c)
Question from he Republic of Trinidad and Tobago, Trinidad, West Indies:
What the pros and cons of the A1c and fructosamine tests? I have read that the fructosamine is a less subjective and a more reliable and stable test than the A1c.
Fructosamine is a less expensive test to perform than the hemoglobin A1c It also reflects blood sugars over about six weeks, about half that for the A1c. There is also a meter available for home testing of fructosamine, and although there is a home test kit for A1c the sample must be sent in to the laboratory. For these reasons it is sometimes used, but in the great bulk of clinical practise and in research reports, it is the A1c test that is quoted.
Perhaps the two most important reasons for this are first that A1c measures can now be made at the time of the office visit and second that in North America and Europe the recommended interval between clinic visits for most people with diabetes (without complications) is about three months. Accuracy depends more on how the tests are carried out than on the methodology. The 95% confidence limits for the most widely used office A1c test, which requires no special skills to perform, is now less than 5% and in that it is usually done as part of an office visit the results are considered generally more reliable than both a fructosamine test and a home derived test.
[Editor’s comment: See Glycohemoglobin and similar diabetes tests , at the Diabetes Monitor, for some additional thoughts.