title: The Glycated Albumin (GA) to HbA1c Ratio Reflects Shorter-Term Glycemic Control than GA: Analysis of Patients with Fulminant Type 1 Diabetes.
abstract: BACKGROUND
  Glycated albumin (GA) reflects shorter-term glycemic control than HbA1c. We have reported that HbA1c is paradoxically increased in diabetic patients whose glycemic control deteriorated before ameliorating. In this study, we analyzed paradoxical increases of glycemic control indicators after treatment in patients with fulminant type 1 diabetes (FT1D). We also investigated whether the GA/HbA1c ratio may reflect shorter-term glycemic control than GA.
  
  
  METHODS
  Five FT1D patients whose post-treatment HbA1c and GA levels were measured were enrolled. We also used a formula to estimate HbA1c and GA from the fictitious models of changes in plasma glucose in FT1D patients. In this model, the periods during which HbA1c, GA, and the GA/HbA1c ratio were higher than at the first visit were compared. In addition, the half-life for the GA/HbA1c ratio was calculated in accordance with the half-lives for HbA1c and GA (36 and 14 days, respectively).
  
  
  RESULTS
  In all FT1D patients, HbA1c levels 2-4 weeks after treatment were increased, with three patients (60%) experiencing an increase of GA levels. In contrast, an increase of the GA/HbA1c ratio was observed in only one patient. In all of the different models of changes in plasma glucose in FT1D patients, the length of time during which the values were higher than at the first visit was in the order of HbA1c > GA > GA/HbA1c ratio. The half-life for the GA/HbA1c ratio was 9 days, shorter than GA.
  
  
  CONCLUSIONS
  These findings suggest that the GA/HbA1c ratio reflects shorter-term glycemic control than GA.
authors.affiliation: Department of Internal Medicine, Hakuhokai Central Hospital, Hyogo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Inada
authors.affiliation: Department of Internal Medicine, Naga Municipal Hospital, Wakayama, Japan.
authors.forename: Taisei
authors.initials: T
authors.lastname: Nakao
authors.affiliation: Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Kawamori
authors.affiliation: Department of Medicine, Nissay Hospital, Osaka, Japan.
authors.forename: Soji
authors.initials: S
authors.lastname: Kasayama
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006207:Half-Life; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D008875:Middle Aged; D008954:Models, Biological; D012709:Serum Albumin / Q000032:analysis*; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin
keywords: GA/HbA1c ratio; HbA1c; glycated albumin; half-life; paradoxical increase