Diagnostic accuracy of glycated albumin and fructosamine for detecting diabetes and prediabetes in adults: a systematic review and meta-analysis protocol.
8 affiliations
- 1Department of Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka. [email protected].
- 2NK Ceylon Institute of Medical Research, Negombo, Sri Lanka. [email protected].
- 3Department of Physiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
- 4Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
- 5Dorevitch Pathology, Melbourne, VIC, Australia.
- 6Department of Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
- 7University Medical Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.
- 8Department of Medicine, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
Abstract
Background
Early and accurate diagnosis of diabetes is essential to prevent long-term complications. While the oral glucose tolerance test (OGTT) is the reference standard, it is often impractical. Glycated hemoglobin (HbA1c) is widely used instead, but it can be unreliable in conditions that alter erythrocyte lifespan. Glycated albumin (GA) and fructosamine (FA) represent promising, short-term glycemic biomarkers that are independent of red blood cell turnover; however, their exact diagnostic accuracy remains uncertain.Methods
This systematic review and meta-analysis protocol follows PRISMA-DTA guidelines. We will search MEDLINE (via PubMed), Scopus, and Web of Science from inception to December 2025 for observational studies evaluating GA or FA against OGTT in adult populations. Two independent reviewers will screen studies, extract data, and assess methodological quality using the QUADAS-2 tool. Diagnostic accuracy measures will be pooled using a bivariate random-effects model, and hierarchical summary receiver operating characteristic (HSROC) curves will be constructed.Discussion
This review will provide comprehensive evidence on the diagnostic performance of GA and FA, clarifying their potential utility as alternatives to HbA1c. Findings will help inform clinical practice, laboratory decision-making, and future guideline development, particularly for populations where HbA1c testing is unreliable.Systematic review registration
PROSPERO CRD420251236959.
Related
- Diagnostic accuracy of ultrasound in detecting pathological complete response to neoadjuvant chemotherapy in breast cancer: a systematic review and diagnostic test accuracy meta-analysis.
- Diagnostic Performance of Color Doppler Ultrasound for Detecting Nuchal Cord and Associated Immediate Neonatal Outcomes at Term in Uganda: A Prospective Diagnostic‐Accuracy Cohort Study
- Diagnostic accuracy of urine test strips for CSF analysis: high sensitivity in detecting blood, low sensitivity but high specificity in detecting inflammation
- Trimester-Specific Diagnostic Accuracy of Amniotic Fluid α-Fetoprotein for Detecting Preterm Premature Rupture of Membranes Versus AmniSure
- Diagnostic Accuracy of GPT-5 in Detecting and Localizing Acute Ischemic Stroke on Isolated Diffusion-Weighted Imaging: A Retrospective Case–Control Study
BibTeX
@article{fernando2026diagnostic,
title = {{Diagnostic accuracy of glycated albumin and fructosamine for detecting diabetes and prediabetes in adults: a systematic review and meta-analysis protocol.}},
author = {Kavindya Fernando and Dulani Kottahachchi and Lochana Pasan and Chamodi Rathnaweera and Bktp Dayanath and Shiromi Perera and Anuja Premawardhena},
journal = {Systematic reviews},
year = {2026},
month = jul,
doi = {10.1186/s13643-026-03273-z},
url = {https://europepmc.org/article/MED/42902413},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Diagnostic accuracy of glycated albumin and fructosamine for detecting diabetes and prediabetes in adults: a systematic review and meta-analysis protocol.
AU - Kavindya Fernando
AU - Dulani Kottahachchi
AU - Lochana Pasan
AU - Chamodi Rathnaweera
AU - Bktp Dayanath
AU - Shiromi Perera
AU - Anuja Premawardhena
PY - 2026
DA - 2026/07/01
JO - Systematic reviews
DO - 10.1186/s13643-026-03273-z
UR - https://europepmc.org/article/MED/42902413
AB - Background Early and accurate diagnosis of diabetes is essential to prevent long-term complications. While the oral glucose tolerance test (OGTT) is the reference standard, it is often impractical. Glycated hemoglobin (HbA1c) is widely used instead, but it can be unreliable in conditions that alter erythrocyte lifespan. Glycated albumin (GA) and fructosamine (FA) represent promising, short-term glycemic biomarkers that are independent of red blood cell turnover; however, their exact diagnostic accuracy remains uncertain.Methods This systematic review and meta-analysis protocol follows PRISMA-DTA guidelines. We will search MEDLINE (via PubMed), Scopus, and Web of Science from inception to December 2025 for observational studies evaluating GA or FA against OGTT in adult populations. Two independent reviewers will screen studies, extract data, and assess methodological quality using the QUADAS-2 tool. Diagnostic accuracy measures will be pooled using a bivariate random-effects model, and hierarchical summary receiver operating characteristic (HSROC) curves will be constructed.Discussion This review will provide comprehensive evidence on the diagnostic performance of GA and FA, clarifying their potential utility as alternatives to HbA1c. Findings will help inform clinical practice, laboratory decision-making, and future guideline development, particularly for populations where HbA1c testing is unreliable.Systematic review registration PROSPERO CRD420251236959.
SN - 2046-4053
ER -