DOI: 10.36347/sjams.2019.v07i02.068

Pages: 752-757

A study was conducted in Government Stanley Medical College and Hospital, in the Department of Biochemistry, to assess nail keratin glycation as an indicator of long term glycemic control. A total of 70 individuals, 35 known diabetic patients and 35 healthy individuals were enrolled for the study. The patients were longitudinally followed up for three months to assess their glycemic status. The aim was to establish whether the nail fructosamine could be used to determine the glycemic status of the diabetic patients over the preceding three months which is the turnover time of the nail from root to the free edge. HbA1C estimation was used to confirm the changes in the patient’s glycemic status and compared with nail fructosamine. A linear relationship was established after analysis of the results (p value 0.009). There was also a significant difference of nail fructosamine between cases and controls ( p value 0.09).The mean value of nail fructosamine in controls (2.18μmol/g equivalents of nail ) was within the physiological range (2.0-2.5μmol/g) as reported by Goldsmith et al in 1985.The nail fructosamine levels determined in diabetic cases were above the physiological range (2.68 and 3.1μmol/g).The fasting blood glucose and serum fructosamine were also measured for assessing the blood glucose levels in both cases and controls. These parameters on comparison with nail fructosamine showed linear relationship. To conclude, the nail fructosamine assay could be standardized for determining the long term glycemic status of an individual as well as in people with Diabetes Mellitus. The reference range in south Indian population needs to be established. The interference like drugs and other dietary substances which might react with NitroBlueTetrazolium need to be studied and the procedure can be used as routine laboratory investigations to assess the blood glucose levels on long term basis.