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Serum fructosamine as a marker of 5‐year risk of developing diabetes mellitus in patients exhibiting stress hyperglycaemia
Author(s) -
Wahid S. T.,
Sultan J.,
Handley G.,
Saeed B. O.,
Weaver J. U.,
Robinson A. C. J.
Publication year - 2002
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2002.00730.x
Subject(s) - fructosamine , medicine , diabetes mellitus , endocrinology , gastroenterology
Aims We examined whether the level of random serum glucose (RSG) in subjects exhibiting stress hyperglycaemia is a useful marker of the future risk of developing diabetes mellitus (DM), and whether serum fructosamine is of any additional value. Methods All non‐diabetic adults attending Accident and Emergency in 1994–1995, who had venesection, were studied. Serum fructosamine and RSG were routinely measured in all such patients. Using the laboratory biochemistry database the number of subjects with stress hyperglycaemia (RSG > 11.1 mmol/l) was determined, and their corresponding fructosamine values were recorded. The number of subjects who developed DM over the following 5 years was determined. Results Three hundred and seventeen patients had stress hyperglycaemia, and follow‐up data were available on 224 patients. Of these patients, 63 (28%) had developed DM over the 5 years follow‐up period. RSG and fructosamine levels at baseline of patients subsequently developing DM were (mean ± sd (range)) 16.7 ± 7.0 (11.2–55.0) mmol/l and 3.3 ± 0.6 (1.3–4.5) mmol/l, respectively. The patients who did not develop DM had a similar baseline RSG, 15.9 ± 3.3 (11.2–30.6) mmol/l; P = 0.170, but lower baseline fructosamine, 2.4 ± 0.4 (1.6–3.8) mmol/l; P < 0.001. Receiver‐operating characteristics showed that a serum fructosamine ≥ 2.8 mmol/l was a useful marker of the future risk of DM (75% sensitivity, 74% specificity, 53% positive and 88% negative predictive power). Conclusions The level of RSG in stress hyperglycaemia does not predict the future development of DM. Raised serum fructosamine is a more useful marker of future DM risk than RSG alone. Further prospective studies are needed.