Prevalence of diabetes reported in Korea vary from 0.91to 3.5%. The oral glucose tolerance test or intravenous glucose tolerance test has been widely used for the diagnosis of diabetes and impaired glucose tolerance. Because of the lack of the
lack of
standardization and time consuming procedure, inconvenience of diagnosis of diabetes and requirement of patient cooperation, not always successful, determination of glycosylated hemoglobin(HbAlc) and more recently fructosamine were introduced as
an
alternative screening procedure. The aim of this study was to compare the tests of fructosamine and HbAlc for the use of diabetes screening. Subjects were 137 in total, of whom 83 visited H Institute fro health check and 54 were diabetes patients
visiting Y University Hospital from January to April, 1992. The individuals were classified as normal healthy healthy group(n=61), impaired glucose tolerance group(n=22) and diabetes mellitus group(n=54) based on the criteria by World Health
organization. Tests including blood glucose, HbAlc and fructosamine after fasting and 2-h ropostload blood glucose were done.
The results are as follows:
Correlation between fasting blood glucose and HbAlc in healthy subjects were poor(r=0.25, p>0.01). However, impaired glucose tolerance and diabetes group showed good correlation(r=0.56 P<0.01, r=0.66 P<0.01).
2. Correlation between fasting blood glucose and fructosamine in healthy subjects were not good(r=0.66 P<0.01). However, impaired glucose and diabetes group showed good correlation(r=0.66 P<0.01, r=0.65 P<0.001).
3. The HbAlc was not significantly different in all 137 subjects with fasting blood glucose but there were significant correlations between fasting blood glucose and fructosamine level(r=0.88 P<0.001).
4. Sensitivity and specificity and specificity of HbAlc in normal healthy group and diabetes group were high (98.1%, 96.7%, respectively) and fructoamine also showed good sensitivity(98.1%) and specificity(86.9%).
5. Separating impaired glucose tolerance from healthy subjects who had blood glucose level less than 140mg/dl, the sensitivity of HbAlc was low(50%) whereas specificity was 96.7%, fructosamine was less sensitive and less specific than
HbAlc(45.5%,
86.9% respectively).
In conclusion, neither the HbAlc not the fructosamine test is useful for screening diabetes and impaired glucose tolerance group. However, if subjects show normal blood glucose level and abnormal HbAlc or fructosmaine level, it will at least give
the
chance to perform oral glucose tolerance test to diagnose diabetes or impaired glucose tolerance.
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