Utility of glycated albumin in diagnosis of type 2 diabetes: An Indian perspective study

Abstract

Glycated Albumin(GA) gives an estimate of short-term average glycemic status. It is used on monthly basis to assess glycemic control in diabetics to attain treatment goals and prevent long term complications. Recommendation of Glycated Hemoglobin(HbA1c) for diagnosis of diabetes mellitus has evoked mixed response worldwide. We reviewed a number of published articles to analyze the pros and cons of using both Glycated Hemoglobin(HbA1c) and Glycated albumin(GA) for diagnosis of Diabetes mellitus in India. We observed that HbA1c has some indisputable advantages over fasting plasma glucose estimation for diagnosing diabetes mellitus, a number of biochemical, clinical and economical factors limit its use as single diagnostic agent. Diagnostic methods and laboratories are insufficiently standardized for HbA1c in India. The clinician must consider the overall patient profile in addition to a number of local variations and disorders especially hemoglobinopathies /anemias before accepting an abnormal HbA1c value. Supportive or repeat tests may be required leading to increase in cost and delay in diagnosis. In the present Indian scenario, especially the fragmented unorganized health care sector in suburban areas, GA test can be accepted as a alternative to HbA1c test in diagnose of diabetes mellitus.