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Koga M, Inada S, Taniguchi J, et al. High glycated albumin (GA) levels and the GA/HbA1c ratio in patients with insulin autoimmune syndrome. Diabetol Int. 2016;8(2):199-204doi: 10.1007/s13340-016-0294-7.
Koga, M., Inada, S., Taniguchi, J., Nakatani, Y., Yoshino, H., Yoshino, G., Okauchi, Y., & Mineo, I. (2017). High glycated albumin (GA) levels and the GA/HbA1c ratio in patients with insulin autoimmune syndrome. Diabetology international, 8(2), 199-204. https://doi.org/10.1007/s13340-016-0294-7
Koga, Masafumi, et al. "High glycated albumin (GA) levels and the GA/HbA1c ratio in patients with insulin autoimmune syndrome." Diabetology international vol. 8,2 (2017): 199-204. doi: https://doi.org/10.1007/s13340-016-0294-7
Koga M, Inada S, Taniguchi J, Nakatani Y, Yoshino H, Yoshino G, Okauchi Y, Mineo I. High glycated albumin (GA) levels and the GA/HbA1c ratio in patients with insulin autoimmune syndrome. Diabetol Int. 2016 Nov 04;8(2):199-204. doi: 10.1007/s13340-016-0294-7. eCollection 2017 Jun. PMID: 30603322; PMCID: PMC6224948.
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Diabetol Int. 2016 Nov 04;8(2):199-204. doi: 10.1007/s13340-016-0294-7. eCollection 2017 Jun.

High glycated albumin (GA) levels and the GA/HbA1c ratio in patients with insulin autoimmune syndrome.

Diabetology international

Masafumi Koga, Shinya Inada, Jun Taniguchi, Yuki Nakatani, Hiroshi Yoshino, Gen Yoshino, Yukiyoshi Okauchi, Ikuo Mineo

Affiliations

  1. Department of Internal Medicine, Hakuhokai Central Hospital, 4-23-1 Higashisonodacho, Amagasaki, Hyogo 661-0953 Japan.
  2. Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan.
  3. 3Department of Diabetes, Tokeidai Memorial Hospital, Sapporo, Japan.
  4. 4Department of Diabetes & Endocrinology, Dokkyo Medical University Nikko Medical Center, Tochigi, Japan.
  5. 5Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
  6. Center for Diabetes, Shin-Suma General Hospital, Kobe, Japan.
  7. 7Diabetes Center, Toyonaka Municipal Hospital, Osaka, Japan.

PMID: 30603322 PMCID: PMC6224948 DOI: 10.1007/s13340-016-0294-7

Abstract

Insulin autoimmune syndrome (IAS) involves not only fasting hypoglycemia, but also postprandial hyperglycemia. In the present study, we hypothesized that glycated albumin (GA) levels and the GA/HbA1c ratio, which reflect fluctuations in plasma glucose levels, are elevated in IAS patients. Four IAS patients were enrolled in the present study. Thirty-two non-diabetic subjects matched for gender, age, and BMI were used as the control group. The fasting plasma glucose levels in the IAS patients were significantly lower than in the control group. However, the oral glucose tolerance test (OGTT) revealed impaired glucose tolerance or diabetes mellitus in all the IAS patients, and thus the OGTT 2-h plasma glucose levels were significantly higher than in the control group. The GA levels and the GA/HbA1c ratio in the IAS patients were significantly higher than in the control group, despite no significant difference in the HbA1c levels between the two groups. In one case in which IAS spontaneously went into remission, there was a significant correlation between anti-insulin antibodies and GA, but not HbA1c. Improvement in glucose fluctuations was observed by continuous glucose monitoring in another patient along with improvement in the clinical symptoms. Furthermore, anti-insulin antibodies, GA, and the GA/HbA1c ratio decreased, but HbA1c did not change significantly in three IAS patients along with the improvement in clinical symptoms. These results suggest that GA and the GA/HbA1c ratio are useful indicators for determining the level of disease activity in IAS patients.

Keywords: Glycated albumin; HbA1c; Hypoglycemia; Insulin antibodies; Insulin autoimmune syndrome; Postprandial hyperglycemia

Conflict of interest statement

The authors declare that they have no conflicts of interest.All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional a

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