This marker measures the total amount of fructosamine (glycated protein) in the blood.
A normal fructosamine level may indicate good glucose control and that the current treatment plan is effective for the individual. Likewise, a trend from high to normal fructosamine levels may indicate that changes to the treatment regimen have been effective.
Glucose molecules will permanently combine with proteins in the blood in a process called glycation. These proteins include albumin, the principal protein in the fluid portion of blood (serum), as well as other serum proteins and hemoglobin, the major protein found inside red blood cells (RBCs). The more glucose that is present in the blood, the greater the amount of glycated proteins that are formed. These combined molecules persist for as long as the protein or RBC is present in the blood and provide a record of the average amount of glucose that has been present in the blood over that time period.
Since the lifespan of RBCs is about 120 days, glycated hemoglobin (hemoglobin A1c) represents a measurement of the average blood glucose level over the past 2 to 3 months. Serum proteins are present in the blood for a shorter time, about 14 to 21 days, so glycated proteins, and the fructosamine test, reflect average glucose levels over 2 to 3 weeks.
Keeping blood glucose levels as close as possible to normal helps individuals with diabetes to avoid many of the complications and progressive damage associated with elevated glucose levels. Good diabetic control is achieved and maintained by daily (or even more frequent) self-monitoring of glucose levels in people treated with insulin and by occasional monitoring of the effectiveness of treatment using the A1c test or the fructosamine test.
What does it mean if your Fructosamine result is too high?
A high fructosamine level means that the average blood glucose over the previous 2 to 3 weeks has been elevated. In general, the higher the fructosamine level, the higher the average blood glucose level. Monitoring the trend of values may be more important than a single high value.
A trend from a normal to a high fructosamine level may indicate that glucose control is not adequate. This, however, does not pinpoint the cause. A review and adjustment to diet and/or medication may be required to help get glucose under control. Illness and significant stress can also temporarily raise blood glucose levels so these factors may also be taken into account when interpreting results.
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What does it mean if your Fructosamine result is too low?
Low fructosamine levels in the blood typically indicate a lower average blood glucose concentration over the preceding two to three weeks, reflecting a shorter-term glycemic control compared to hemoglobin A1c, which represents a three-month average. This decrease in fructosamine can be seen in individuals with hypoglycemia or those who have achieved better glycemic control due to changes in diet, exercise, or diabetes medication. However, it's important to note that fructosamine levels can also be affected by other factors independent of glucose levels. For instance, lower fructosamine levels can occur in conditions associated with a rapid turnover of proteins, such as hyperthyroidism, or in situations leading to a reduction in serum proteins like malnutrition or severe liver disease. Therefore, while low fructosamine levels can suggest good blood sugar control, they must be interpreted in the context of the individual's overall health, medical history, and concurrent conditions.
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