Applied Biosciences· 2026Q1· Review
Beyond HbA1c: Current and Emerging Glycation Biomarkers for Diabetes Diagnosis, Monitoring and Risk Stratification
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- Q1SCImago
- 2026year
Short summary
Plasma proteins like albumin and immunoglobulins are glycated, offering alternatives to HbA1c for diabetes monitoring, with fructosamine, glycated albumin (GA), and glycated CD59 (GC59) in clinical use, and AGEs receptors (sRAGE) and small-molecule AGEs (CML, CEL) under evaluation.
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Key points
- HbA1c limitations due to variable total hemoglobin levels necessitate alternative glycemic biomarkers.
- Fructosamine, glycated albumin (GA), and glycated CD59 (GC59) are established clinical glycation biomarkers.
- Emerging biomarkers include AGEs receptors (sRAGE) and small-molecule AGEs (CML, CEL).
- Non-invasive measurement of skin AGEs fluorescence is a potential future diagnostic approach.
- Distinguishing glycation from glycosylation is crucial for accurate diabetes diagnosis.
AI-generated from the title and abstract; the full text is not read.
Abstract
In patients with diabetes, the concentration of glycated proteins increases. Among them is glycated hemoglobin (HbA1c), which is currently the standard biomarker for assessing long-term glycemic control. However, this parameter has certain limitations, as several medical conditions can affect total hemoglobin levels and, consequently, HbA1c concentrations. Therefore, alternative biomarkers for glycemic monitoring are sought. Other plasma proteins, including albumins and immunoglobulins, are also glycated. In practice, fructosamine and glycated albumin (GA) and glycated CD59 (GC59) are used. Still not established in diagnostics, but scientifically widely evaluated, are also parameters such as AGEs receptors, especially sRAGE, and various types of small-molecule AGEs, such as Nε-carboxymethyl-lysine (CML) and Nε-carboxyethyl-lysine (CEL). The possibility of non-invasive measurement of AGEs fluorescence in the skin is also discussed. In addition to reviewing glycation parameters, this review emphasizes the importance of distinguishing glycation from glycosylation and highlights the need for timely and accurate diagnosis to help curb the growing burden of diabetes in developed countries. It also discusses future perspectives on the use of glycation parameters in diabetes diagnosis.
The authors' abstract, as published at the source. Applied Biosciences, 2026 · DOI ↗
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Field: Clinical Biochemistry
Clinical BiochemistryBiochemistry, Genetics and Molecular Biology