Haemoglobin A1c or Glycated Albumin for Diagnosis and Monitoring Diabetes: An African Perspective.

Diabetes mellitus (DM) has reached epidemic proportions across the globe with the largest increases seen in sub-Saharan Africa. Those that are diagnosed are largely poorly controlled. This review summarizes the limitations of the use of glycated haemoglobin (HBA1c) in Africa and current knowledge on the utility of glycated albumin and fructosamine in African patients. The diagnosis and monitoring of DM in African patients may be compromised by associated conditions like sickle cell anaemia, chronic kidney disease and HIV infection. Glycated albumin reflects short term glycaemia and is not affected by many conditions that alter HbA1c. It can be measured enzymatically, and this review discusses methods for analysis, and discusses the advantages and limitations in specific situations with an emphasis on conditions that also affect HbA1c.