Abstract
It is well known that red cell half-survival time (RCST) is shortened with reduced serum protein concentration in liver cirrhosis.In this study we investigated the best index of glycemic control among HbA1c, fructosamine (FRT), and 1, 5-anhydroglucitol (AG), in non insulin dependent diabetes mellitus complicated with liver cirrhosis (NIDDM-LC).
In 18 NIDDM-LC patients, the level of HbAic correlated with the fasting plasma glucose (FPG) level of one month earlier, while the level of FRT and AG did not correlate with those of two weeks earlier and the test day, respectively.
When NIDDM-LC patients were divided into two groups, group A, having 19 days or more RCST, and group B, having 18 days or less RCST, liver function was more damaged in group B than in group A. In group A, there was a positive correlation between HbA1c and the FPG level of one month earlier or FRT and that of two weeks earlier, while a correlation was noted only between HbAjc and the FPG level of one month earlier in group B. These results suggest that FRT is not appropriate as a glycemic control index in NIDDM-LC patients with increased hepatic dysfunction. The level of HbAic in NIDDM-LC patients was significantly lower(ranging from 0.5 to 2.2%, with a mean of 1.7%) than that in 30 FPG-matched, NIDDM-LC patients.
These findings indicate that, while HbAlc in NIDDM LC patients shows lower levels than in NIDDM patients, it is more useful than serum FRT and AG as an index of glycemic control.
