Credibility of measurement of fructosamine and hemoglobin A1C in estimating blood glucose level of diabetic patients with thalassemia major

Background and Aim: Patients with thalassemia major are classified in high risk group for diabetes mellitus, and therefore monitoring blood glucose level has a vital importance in these people. As high fetal hemoglobin level in thalassemia patients interferes with measurement of glycosylated hemoglobin (hemoglobin A1C), fructosamine evaluation as an alternative approach is suggested.Materials and Methods: This descriptive study was carried out on 33 diabetes mellitus patients with beta-thalassemia (21 female and 12 male cases). The following biochemical measurements were done: blood glucose level through biochemical glucose oxidation method, fructosamine by colorimetry, hemoglobin A1c by immunoturbidimetry, serum ferritin by chemiluminescence and fetal hemoglobin by HPLC methods. Using SPSS software v18.0, statistical analysis was done and correlation between fructosamine and hemoglobin A1c (Pearson’s correlation) and linear regression were investigated. p<0.05 was considered as statistically significant.Results: In female and male patients, blood glucose levels were 204±103 mg/dL and 224±101 mg/dL (p=0.63), fetal hemoglobin were 9%±7% and 13%±9% (p=0.22); serum ferritin levels were 1744±1534 ng/mL and 3253±1773 ng/mL (p=0.96), respectively. Mean serum fructosamine level was 442±124 mmol/L and glycosylated hemoglobin amount was 8.9%±1.8%. These two parameters showed significant correlation (r=0.69, p<0.01). Blood glucose level with hemoglobin A1c (r=0.75, p<0.01) and fructosamine (r=0.54, p<0/01) showed a significant correlation.Conclusion: In diabetic patients with thalassemia major who have frequent blood transfusion, evaluation of serum fructosamine and glycosylated hemoglobin levels are both reliable approaches for estimating blood glucose levels and the two methods can be used alternatively.