Table of ContentsView AllTable of ContentsPurposeBenefitsLimitationsHow It’s DoneNormal RangeOther ConsiderationsFAQs
Table of ContentsView All
View All
Table of Contents
Purpose
Benefits
Limitations
How It’s Done
Normal Range
Other Considerations
FAQs
The fructosamine and A1C tests for diabetes both measureblood sugar. But there are differences, with the fructosamine test measuring average blood glucose levels across two or three weeks prior to the test date and thehemoglobin A1C test(HbA1c) measuring across two to four months.
The shorter fructosamine time window is not sufficient for determining a long-term prognosis.The fructosamine test measures glycated proteins (not glycated hemoglobin) that circulate in the blood for only 14 to 21 days.Measuring these proteins provides a picture of the amount of sugar in your blood for just that time period.
While the A1C test is now generally preferred, fructosamine tests are more accurate with certain health conditions and situations.
This article explains benefits and limitations of both the fructosamine and A1C tests, and why each may be used. It explains what the results mean and how you can convert the test results from fructosamine to A1C.
Verywell / Hugo Lin
Purpose of the Fructosamine Test
Unlike the A1C test, the fructosamine test is not used as a screening test for people who do not havediabetesor who have well-controlled diabetes.Instead, the fructosamine test may be used in situations in which the A1C test is less reliable or doesn’t offer the same information.
Benefits of Fructosamine Test
The fructosamine test may be more useful in certain situations, like managing diabetes in the short term, or with certain health conditions. For example, it may be used if you’ve had a recent change in your medicines orinsulin, as it can help gauge the effectiveness of the new treatments in a more immediate time window.
The test may also be used during pregnancy when your body is changing constantly, which may lead to falsely low A1C results.
Health conditions in which the fructosamine test may offer benefits include:
Fructosamine may be a useful test for people who develop gestational diabetes (diabetes during pregnancy) because changes in red blood cells and rapid blood sugar increases can make A1C results less reliable.
Fructosamine, the A1C Test, and RaceUse of the fructosamine test may include considerations based on race and ethnicity. The A1C test results show higher levels in Black, Asian, and Hispanic populations when compared with tests in White people, even though their blood sugar levels are the same. The A1C has raised concern over potential misdiagnosis, meaning that additional tests like the fructosamine may be helpful.
Fructosamine, the A1C Test, and Race
Use of the fructosamine test may include considerations based on race and ethnicity. The A1C test results show higher levels in Black, Asian, and Hispanic populations when compared with tests in White people, even though their blood sugar levels are the same. The A1C has raised concern over potential misdiagnosis, meaning that additional tests like the fructosamine may be helpful.
Drawbacks of Fructosamine Test
Some healthcare providers may be moving away from the fructosamine test because of its limitations, including accuracy in assessing long-term complications of diabetes. A 2016 review concluded that the fructosamine test doesn’t have enough evidence to support its use.
The authors note that a different test that measures glycated albumin—which also reveals blood sugar levels over the short term—shows promise in most accurately identifyingprediabetesin African-Americans and those who are not obese.
How the Fructosamine Test Is Done
Risks are minimal, as with any blood draw, and no special preparation (e.g., fasting) is required.
A home-based fructosamine test was discontinued in 2002 because it wasn’t accurate. The A1C test also needs to be done using certified and standardized methods.
Normal Range for Fructosamine Test
It’s not entirely clear what fructosamine levels indicate and how they correlate to diabetes or its complications, but the following guide is suggested:
High fructosamine levels indicate high average blood glucose levels took place in the previous two to three weeks. Usually, a trend is monitored with repeat testing, whether that is of fructosamine levels or other indicators, such as glycated albumin or HbA1c.
If the results remain high, it shows you have not had good blood glucose control. Your healthcare provider will try to determine the cause and help you adjust your medications, diet, and other factors.
Reference Ranges for A1CFructosamine results may be considered alongside the HbA1C and other tests. The reference ranges for A1C results are:No diabetes: below 5.7%Borderline/prediabetes: 5.7% to 6.4%Diabetes: 6.5% or higher
Reference Ranges for A1C
Fructosamine results may be considered alongside the HbA1C and other tests. The reference ranges for A1C results are:No diabetes: below 5.7%Borderline/prediabetes: 5.7% to 6.4%Diabetes: 6.5% or higher
Fructosamine results may be considered alongside the HbA1C and other tests. The reference ranges for A1C results are:
Converting Fructosamine to A1C
One formula used to convert fructosamine to A1C uses the fructosamine level (the mmol/L) x 0.017 + 1.61 to arrive at the hemoglobin A1C as a percentage.
Other mathematical equations also may be used, and the numbers may vary depending on a person’s overall health, weight, and lifestyle choices like exercise.
What Is Diabetic Ketoacidosis (DKA)?
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Sometimes, the reliability of the fructosamine test can be compromised. Any condition that affects serum albumin production, either increasing or decreasing turnover, may affect the reliability of the fructosamine test.
Some examples of these conditions include:
In addition, high levels of ascorbic acid (vitamin C) can interfere with the reliability of the test. Therefore, patients should abstain from ascorbic acid supplements for a minimum of 24 hours prior to sample collection.
The Chinese herb Polygalae Radix may also affect results.
A Word From Verywell
A fructosamine test is likely to be part of a larger group of tests your healthcare provider orders. Take your time to review your results, and be sure to ask questions about anything you don’t understand.
Getting abnormal test results can be worrisome, but remember there aremany easy waysyou can take control of your blood sugar with diet, medication, and other lifestyle changes, such asexercise. Use your test results as a motivator to learn more about diabetes and make simple changes so you can see improvement the next time you’re tested.
Frequently Asked Questions
Anemia does not affect blood glucose levels (blood sugar). However, the presence of anemia can interfere with blood glucose readings and cause missed readings ofhypoglycemia(low blood sugar). In response, a mathematical formula has been created to avoid incorrectglucometerreadings.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.6. Glycemic targets: Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement 1):S83–S96. doi:10.2337/dc22-S006Nansseu JR, Fokom-Domgue J, Noubiap JJ, Balti EV, Sobngwi E, Kengne AP.Fructosamine measurement for diabetes mellitus diagnosis and monitoring: a systematic review and meta-analysis protocol.BMJ Open. 2015;5(5). doi:10.1136/bmjopen-2015-007689Danese E, Montagnana M, Nouvenne A, Lippi G.Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes.J Diabetes Sci Technol. 2015;9(2):169–176. doi:10.1177/1932296814567227Mohsin ZA, Paul A, Devendra S.Pitfalls of using HbA1c in the diagnosis and monitoring of diabetes.London Journal of Primary Care. 2015;7(4):66-69. doi:10.1080/17571472.2015.11493437Welsh KJ, Kirkman MS, Sacks DB.Role of glycated proteins in the diagnosis and management of diabetes: research gaps and future directions.Dia Care. 2016;39(8):1299-1306. doi:10.2337/dc15-2727Fayyaz B, Rehman HJ, Minn H.Interpretation of hemoglobin A1C in primary care setting.J Community Hosp Intern Med Perspect. 2019 Feb 11;9(1):18-21. doi:10.1080/20009666.2018.1559432.Malmström H, Walldius G, Grill V, Jungner I, Gudbjörnsdottir S, Hammar N.Fructosamine is a useful indicator of hyperglycaemia and glucose control in clinical and epidemiological studies – cross-sectional and longitudinal experience from the amoris cohort. Hribal ML, ed.PLoS ONE. 2014;9(10):e111463. doi:10.1371/journal.pone.0111463American Diabetes Association Professional Practice Committee.15. Management of diabetes in pregnancy:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S232-S243. doi:10.2337/dc22-S015Johns Hopkins Medicine.Alternative markers of glycemia: fructosamine, glycated albumin, 1,5-AG.American Diabetes Association Professional Practice Committee.2. Classification and diagnosis of diabetes:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S17-S38. doi:10.2337/dc22-S002Henderson WO, Parker MH, Batch BC.How should you assess glycemic control if the hemoglobin A1c is inaccurate or uninterpretable?Cleve Clin J Med. 2021 Feb 1;88(2):81-85. doi:10.3949/ccjm.88a.American Diabetes Association.Common terms.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.6. Glycemic targets: Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement 1):S83–S96. doi:10.2337/dc22-S006Nansseu JR, Fokom-Domgue J, Noubiap JJ, Balti EV, Sobngwi E, Kengne AP.Fructosamine measurement for diabetes mellitus diagnosis and monitoring: a systematic review and meta-analysis protocol.BMJ Open. 2015;5(5). doi:10.1136/bmjopen-2015-007689Danese E, Montagnana M, Nouvenne A, Lippi G.Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes.J Diabetes Sci Technol. 2015;9(2):169–176. doi:10.1177/1932296814567227Mohsin ZA, Paul A, Devendra S.Pitfalls of using HbA1c in the diagnosis and monitoring of diabetes.London Journal of Primary Care. 2015;7(4):66-69. doi:10.1080/17571472.2015.11493437Welsh KJ, Kirkman MS, Sacks DB.Role of glycated proteins in the diagnosis and management of diabetes: research gaps and future directions.Dia Care. 2016;39(8):1299-1306. doi:10.2337/dc15-2727Fayyaz B, Rehman HJ, Minn H.Interpretation of hemoglobin A1C in primary care setting.J Community Hosp Intern Med Perspect. 2019 Feb 11;9(1):18-21. doi:10.1080/20009666.2018.1559432.Malmström H, Walldius G, Grill V, Jungner I, Gudbjörnsdottir S, Hammar N.Fructosamine is a useful indicator of hyperglycaemia and glucose control in clinical and epidemiological studies – cross-sectional and longitudinal experience from the amoris cohort. Hribal ML, ed.PLoS ONE. 2014;9(10):e111463. doi:10.1371/journal.pone.0111463American Diabetes Association Professional Practice Committee.15. Management of diabetes in pregnancy:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S232-S243. doi:10.2337/dc22-S015Johns Hopkins Medicine.Alternative markers of glycemia: fructosamine, glycated albumin, 1,5-AG.American Diabetes Association Professional Practice Committee.2. Classification and diagnosis of diabetes:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S17-S38. doi:10.2337/dc22-S002Henderson WO, Parker MH, Batch BC.How should you assess glycemic control if the hemoglobin A1c is inaccurate or uninterpretable?Cleve Clin J Med. 2021 Feb 1;88(2):81-85. doi:10.3949/ccjm.88a.American Diabetes Association.Common terms.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Diabetes Association.6. Glycemic targets: Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement 1):S83–S96. doi:10.2337/dc22-S006Nansseu JR, Fokom-Domgue J, Noubiap JJ, Balti EV, Sobngwi E, Kengne AP.Fructosamine measurement for diabetes mellitus diagnosis and monitoring: a systematic review and meta-analysis protocol.BMJ Open. 2015;5(5). doi:10.1136/bmjopen-2015-007689Danese E, Montagnana M, Nouvenne A, Lippi G.Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes.J Diabetes Sci Technol. 2015;9(2):169–176. doi:10.1177/1932296814567227Mohsin ZA, Paul A, Devendra S.Pitfalls of using HbA1c in the diagnosis and monitoring of diabetes.London Journal of Primary Care. 2015;7(4):66-69. doi:10.1080/17571472.2015.11493437Welsh KJ, Kirkman MS, Sacks DB.Role of glycated proteins in the diagnosis and management of diabetes: research gaps and future directions.Dia Care. 2016;39(8):1299-1306. doi:10.2337/dc15-2727Fayyaz B, Rehman HJ, Minn H.Interpretation of hemoglobin A1C in primary care setting.J Community Hosp Intern Med Perspect. 2019 Feb 11;9(1):18-21. doi:10.1080/20009666.2018.1559432.Malmström H, Walldius G, Grill V, Jungner I, Gudbjörnsdottir S, Hammar N.Fructosamine is a useful indicator of hyperglycaemia and glucose control in clinical and epidemiological studies – cross-sectional and longitudinal experience from the amoris cohort. Hribal ML, ed.PLoS ONE. 2014;9(10):e111463. doi:10.1371/journal.pone.0111463American Diabetes Association Professional Practice Committee.15. Management of diabetes in pregnancy:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S232-S243. doi:10.2337/dc22-S015Johns Hopkins Medicine.Alternative markers of glycemia: fructosamine, glycated albumin, 1,5-AG.American Diabetes Association Professional Practice Committee.2. Classification and diagnosis of diabetes:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S17-S38. doi:10.2337/dc22-S002Henderson WO, Parker MH, Batch BC.How should you assess glycemic control if the hemoglobin A1c is inaccurate or uninterpretable?Cleve Clin J Med. 2021 Feb 1;88(2):81-85. doi:10.3949/ccjm.88a.American Diabetes Association.Common terms.
American Diabetes Association.6. Glycemic targets: Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement 1):S83–S96. doi:10.2337/dc22-S006
Nansseu JR, Fokom-Domgue J, Noubiap JJ, Balti EV, Sobngwi E, Kengne AP.Fructosamine measurement for diabetes mellitus diagnosis and monitoring: a systematic review and meta-analysis protocol.BMJ Open. 2015;5(5). doi:10.1136/bmjopen-2015-007689
Danese E, Montagnana M, Nouvenne A, Lippi G.Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes.J Diabetes Sci Technol. 2015;9(2):169–176. doi:10.1177/1932296814567227
Mohsin ZA, Paul A, Devendra S.Pitfalls of using HbA1c in the diagnosis and monitoring of diabetes.London Journal of Primary Care. 2015;7(4):66-69. doi:10.1080/17571472.2015.11493437
Welsh KJ, Kirkman MS, Sacks DB.Role of glycated proteins in the diagnosis and management of diabetes: research gaps and future directions.Dia Care. 2016;39(8):1299-1306. doi:10.2337/dc15-2727
Fayyaz B, Rehman HJ, Minn H.Interpretation of hemoglobin A1C in primary care setting.J Community Hosp Intern Med Perspect. 2019 Feb 11;9(1):18-21. doi:10.1080/20009666.2018.1559432.
Malmström H, Walldius G, Grill V, Jungner I, Gudbjörnsdottir S, Hammar N.Fructosamine is a useful indicator of hyperglycaemia and glucose control in clinical and epidemiological studies – cross-sectional and longitudinal experience from the amoris cohort. Hribal ML, ed.PLoS ONE. 2014;9(10):e111463. doi:10.1371/journal.pone.0111463
American Diabetes Association Professional Practice Committee.15. Management of diabetes in pregnancy:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S232-S243. doi:10.2337/dc22-S015
Johns Hopkins Medicine.Alternative markers of glycemia: fructosamine, glycated albumin, 1,5-AG.
American Diabetes Association Professional Practice Committee.2. Classification and diagnosis of diabetes:Standards of medical care in diabetes—2022.Diabetes Care. 2022;45(Supplement_1):S17-S38. doi:10.2337/dc22-S002
Henderson WO, Parker MH, Batch BC.How should you assess glycemic control if the hemoglobin A1c is inaccurate or uninterpretable?Cleve Clin J Med. 2021 Feb 1;88(2):81-85. doi:10.3949/ccjm.88a.
American Diabetes Association.Common terms.
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