Blood biochemistry: fructosamine

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• Glycated protein complexes.
• Forms in blood in non-enzymic, non insulin dependent manner.
• [Fructosamine] proportional to [glucose] over life span of protein (1-2 weeks).
• Provides long term view of average blood glucose .
• Changes in blood glucose are reflected within 7-10 days by change in fructosamine.
• Less affected by short-term factors: stress, feeding, exercise.
   Very useful in cat to differentiate stressed hyperglycemic animals from true diabetics.
• Useful in diagnosis of diabetes and to monitor response to insulin therapy.

• Diabetes mellitus (in presence of hyperglycemia or glycosuria).

Serial tests

• Monitor response to insulin therapy.
• Initial tests every 2-3 weeks
• Thereafter, every 4 months. (Monitor unstable cases more frequently).

• Venous blood.

• 0.5 ml serum or clotted blood.

• Standard venepuncture .

• Sample remains stable during transport to laboratory.

• Single sample at time of diagnosis.
• Subsequent samples at 2-3 week intervals until stable.
• Check every 4-6 months.

• Package according to mail regulations .

• Specialist commercial laboratories.

• Normal range: 140-300 micromol/l.

• 400-450 micromol/l adequate control.
• Insufficient glycemic control >500 micromol/l.
   < 400 micromol/l in diabetic cat receiving insulin indicates glycemic control adequate.

• Overlap in reference range means that normal value does not rule out diabetes mellitus.
   The closer the value is to the reference range the better glycemic control.

• Freezing sample may result in instability of protein complex.

• Elliot D A, Nelson R W, Reusch C E, Feldman E C & Neal L A (1999) Comparison of serum fructosamine and blood glycosylated hemoglobin concentrations for assessment of glycemic control in cats with diabetes mellitus. JAVMA 214, 1795-1798.
• Reusch C E & Tomsa K (1999) Serum fructosamine concentration in cats with overt hyperthyroidism. JAVMA 215, 1297-1300.
• Haberer B and Reusch C E (1998) Glycated hemoglobin in various pathological conditions: investigations based on a new, fully automated method JSAP 39 (11), 510.
• Crenshaw K C, Peterson M E, Heeb LA et al (1996) Serum fructosamine concentrations as an index of glycemia in cats with diabetes mellitus and stress hyperglycemia. JVIM 10, 360-364.
• Reusch C E, Liehs M R, Hoyer M, Vochezer R (1993). A new parameter for diagnosis and metabolic control in diabetic dogs and cats. JVIM 7, 177-182.
• Thorensen S I & Bredal W P (1996) Clinical usefulness of fructosamine measurements in diagnosing and monitoring feline diabetes mellitus. JSAP 37, 84-88.
• Thorensen SI & Bredal WP (1995). Determination of a reference range for fructosamine in feline serum samples. Vet. Res. Comm. 19, 353-361.
• Akol K G, Waddle J R & Wilding P (1992) Glycated hemoglobin and fructosamine in diabetic and non-diabetic cats. JAAHA 28, 227-231.
• Jensen AL (1992) Serum fructosamine in canine diabetes mellitus - an initial study. Vet. Res. Comm. 16, 1-9.

• Jane Miller B VetMed FRCPath MRCVS, North Western Laboratories, Lancefield House, 23 Mains Lane, Little Singleton, Poulton-le-Fylde, Lancashire FY6 7LJ, UK. Tel: +44 (0)1253-899215; Fax: +44 (0)1253-891934; E-mail: nwlabs@nw-labs.co.uk.
• Dr David Bruyette DVM DipACVIM, VCA West Los Angeles, 1818 South Sepulveda Boulevard, Los Angeles, CA 90025, USA.

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