Different behaviour of haemoglobin A1a-c and glycosyl-albumin levels during recovery from diabetic ketoacidosis and non-acidotic coma.

Glycosylated haemoglobin (HbA1a-c) and serum albumin (glycosyl-albumin) have been determined in patients with severe diabetic ketoacidosis and non-acidotic coma. Within one week of therapy the level of glycosyl-albumin decreased from 184 mmol 5-hydroxymethylfurfural (HMF)/mol albumin to 152 mmol HMF/mol albumin (p less than 0.01) and was gradually lowered by some 40% during a period of 17 days. In contrast, the level of HbA1a-c remained unchanged. From these observations and findings in a patient with insulinoma, it appears that glycosyl-albumin provides a more acute measure of variation in relative glycaemia than HbA1a-c, and may prove useful as a measure of medium-term diabetes control.