title: A discrepancy between plasma glycated albumin and HbA1c levels in a patient with steroid-induced diabetes mellitus.
abstract: A 57-year-old man was admitted for the treatment of steroid-induced diabetes mellitus (DM). He also had interstitial pneumonia and, to treat it, 20 mg prednisolone had been started in April 2014. Although glycated haemoglobin (HbA1c) level was 7.8% (62 mmol/mol), his glycated albumin (GA) level was normal (13.9%) and the ratio of GA to HbA1c (GA:HbA1c) was lower than that of normal participants and patients with type 2 DM. Plasma GA and GA:HbA1c levels became persistently lower. In September 2015, HbA1c levels measured by HPLC and immunoprecipitation methods were almost the same (6.8% (51 mmol/mol) and 6.7% (50 mmol/mol), respectively), but GA (10.2%) and GA:HbA1c (1.6) were much lower. We report the case of a patient with DM where steroid administration may have caused a decrease in plasma GA and GA:HbA1c levels via increased albumin turnover.
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Iizuka
authors.affiliation: Gifu University Hospital, Gifu, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takeda
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000378:metabolism; D005786:Gene Expression Regulation / Q000187:drug effects; D005938:Glucocorticoids / Q000009:adverse effects / Q000494:pharmacology*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D017127:Glycation End Products, Advanced; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects / Q000494:pharmacology; D012709:Serum Albumin / Q000378:metabolism*; D000093423:Glycated Serum Albumin
chemical_list: D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D011239:Prednisolone; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human