Do you remember the first time you or a family member was diagnosed with diabetes?

Your healthcare provider probably asked you to stop eating the night before a blood test. The next morning, you may have had a fasting blood glucose test. This provides a snapshot of your body’s response to low blood glucose. But it is only a single snapshot in time. However, some laboratory tests can measure average blood glucose levels over a period of time and are called “alternative markers of glycemia”. These are special compounds in your body that reflect blood glucose levels over anywhere from a few weeks to a few months, giving insights into short- or long-term blood glucose control.

  • Hemoglobin A1c (A1C) is one of the best markers to indirectly monitor blood glucose levels. A1C tracks changes in your glucose levels over a period of 3 months.
  • Fructosamine and glycated albumin: These are used less often than A1C and give a 2-week snapshot of your blood glucose levels.
  • 1,5-anhydroglucitol (1,5-AG): Also used less often than A1C and offers a glimpse of your blood glucose levels within the past 24 hours.


Finding the right fit

Your healthcare provider will focus on diabetes markers that best match your needs. Your lifestyle, medications, health conditions and even your gender can factor into this choice.

Most people will find that A1C levels provide all the information they need to track blood sugar levels over time. But some people may find that alternative markers of blood glucose levels can be helpful, too.

Your healthcare provider is more likely to recommend an alternative marker for monitoring blood glucose levels if:

  • You have changing circumstances. Maybe you visit the provider more than once a month; maybe you are adjusting to a new medication or lifestyle change. If so, you may find that 1,5-AG helps you monitor day-to-day changes in blood glucose.
  • A1C levels aren’t accurate because you have another health condition, such as sickle cell disease, which can sometimes make A1C results difficult to interpret.
  • You are pregnant and need to watch your blood glucose levels extra carefully.
  • The A1C test is too expensive. The low cost and convenience of the fructosamine assay make it a useful alternative to A1C, especially in developing countries. But fructosamine is not perfect. It can give false results if you have liver or kidney disease, or if you have recently had high blood sugar levels.

































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