title: Is glycated albumin useful for differential diagnosis between fulminant type 1 diabetes mellitus and acute-onset autoimmune type 1 diabetes mellitus?
abstract: BACKGROUND
  Markedly elevated plasma glucose and relatively low HbA1c compared to plasma glucose is one diagnostic criterion for fulminant type 1 diabetes mellitus (FT1DM). Glycated albumin (GA) is a glycemic control marker that reflects glycemic control in shorter period than HbA1c. This study investigated whether GA is useful for differential diagnosis between FT1DM and acute-onset autoimmune type 1 diabetes mellitus (T1ADM) or not.
  
  
  METHODS
  This study included 38 FT1DM patients and 31 T1ADM patients in whom both HbA1c and GA were measured at the time of diagnosis.
  
  
  RESULTS
  In FT1DM patients, as compared to T1ADM patients, both HbA1c and GA were significantly lower (HbA1c; 6.6±0.9% vs. 11.7±2.6%, P<0.0001, GA; 22.9±4.8% vs. 44.3±8.3%, P<0.0001). For differential diagnosis between FT1DM and T1ADM, ROC analysis showed that the optimum cut-off value for GA was 33.5% with sensitivity and specificity of 97.4% and 96.8%, respectively, while the optimum cut-off value for HbA1c was 8.7% with sensitivity and specificity of 100% and 83.9%, respectively.
  
  
  CONCLUSIONS
  GA also may be useful for the differential diagnosis between FT1DM and T1ADM when the cut-off value can be set at 33.5%.
authors.affiliation: Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan. Electronic address: m-koga@kawanishi-city-hospital.com.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kanehara
authors.affiliation: Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Bando
authors.affiliation: Department of Medicine, Nissay Hospital, Osaka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Medicine, Nissay Hospital, Osaka, Japan.
authors.forename: Soji
authors.initials: S
authors.lastname: Kasayama
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000145:classification / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012709:Serum Albumin / Q000032:analysis*; D000093423:Glycated Serum Albumin
chemical_list: D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin
keywords: Autoimmune type 1 diabetes mellitus; Fulminant type 1 diabetes mellitus; Glycated albumin; HbA1c