- 期刊
Alternative Biomarkers for Assessing Glycemic Control for the Prognosis and Management of Diabetes
摘要
Diabetes refers to a group of metabolic dysfunctions of multiple etiology marked by chronic hyperglycemia. The frequent evaluation and accurate measurement of glycemic control are cornerstones in the reduction of long-term diabetic complications. Glycemic biomarkers are essential tools used to determine whether a patient with diabetes has achieved glycemic control and maintained it within the target range; notably, they also act as surrogate biomarkers to estimate and reduce the risk of long-term diabetic complications. Although fasting plasma glucose, 2-h postprandial plasma glucose, and random plasma glucose provide information on glycemc control for diabetic diagnosis and management, they do not reflect glycemic control over a period of time. Traditionally, glycated hemoglobin (HbA1c) has been used as the gold standard glycemic control biomarker for long-term glucose monitoring. However, growing evidence indicates that HbA1c is not a suitable indictor as a result of various biological confounders and analytical interferences that limit its accuracy in reflecting true glycemia. Therefore, the use of glycated albumin, fructosamine, and 1,5-anhydroglucitol as well as a continuous glucose monitoring system may complement traditional measures, particularly in circumstances in which the measurement of HbA1c could be unreliable or biased in assessing the risk of diabetic complications. In this review, the suitability of blood glycated proteins as indices of long-term glycemic control was investigated and the selection of the appropriate glycemic biomarkers was outlined based on the clinical status of patients with diabetes. Valuable and useful point-of-care monitoring procedures were provided for the management of diabetes and the prevention of related complications.