Journal of Molecular and Pharmaceutical Sciences
Volume 5, Numéro 1, Pages 53-62
2026-06-30
Hba1c And Fructosamine As Dual Biomarkers Of Glycemic Control In Pediatric Type 1 Diabetes During Ramadan Fasting
Authors : Touaitia Rahima . Boussahia Riadh .
Abstract
Background: Glycated hemoglobin (HbA1c) is the standard biomarker for long-term glycemic control in type 1 diabetes (T1D), but it fails to capture short-term fluctuations. Fructosamine, which reflects glycemia over 2–3 weeks, may provide complementary information during periods of rapid metabolic change, such as Ramadan fasting. Objective: To evaluate short- and medium-term glycemic control in pediatric patients with T1D before and after Ramadan by comparing HbA1c and fructosamine. Methods: This observational study enrolled 18 children (<18 years) with T1D at EL NOUR Medical Laboratory, Tébessa. Blood samples were collected one week before and after Ramadan. Fasting glucose, HbA1c, and fructosamine were measured using validated enzymatic and colorimetric assays. Paired comparisons and correlation analyses were performed. Results: Mean HbA1c increased significantly from 8.69 ± 1.51% pre-Ramadan to 9.34 ± 1.46% post-Ramadan (p = 0.03), indicating deterioration in long-term control. Fructosamine showed a non-significant increase from 406.02 ± 91.03 µmol/L to 426.21 ± 82.14 µmol/L (p = 0.09), though five patients exhibited reductions, suggesting improved short-term control in a subset. Pearson’s analysis demonstrated a moderate positive correlation between HbA1c and fructosamine (r = 0.61). Conclusion: Ramadan fasting was associated with worsening long-term glycemic control in children with T1D, as reflected by HbA1c. Fructosamine revealed heterogeneous short-term responses, underscoring its value as a complementary biomarker for capturing recent glycemic changes. Incorporating fructosamine alongside HbA1c may enhance monitoring and support individualized management of pediatric T1D during Ramadan and other periods of lifestyle modification.
Keywords
Type 1 diabetes ; children ; HbA1c ; fructosamine ; Ramadan ; glycemic control
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