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Breath test may recognize prediabetes, early-stage diabetes in at-risk individuals

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A standard infrared breath analyzer was successful in detecting differences in the excretion pattern of glucose-derived breath carbon dioxide between individuals with prediabetes/early-stage diabetes and those with normal glucose tolerance.

Researchers conducted a study to determine whether differences exist in breath ¹³CO₂ excretion during a standard ¹³C–labeled oral glucose tolerance test in individuals with normal glucose tolerance compared with prediabetes or early-stage diabetes. They collected blood and breath samples at baseline and every 30 minutes during the 10-hour test period.

Age and BMI were similar among individuals with normal glucose tolerance and those with prediabetes and early-stage diabetes. Individuals with prediabetes/early-stage diabetes had higher blood glucose concentrations from baseline to 4.5 hours after glucose ingestion compared with individuals with normal glucose tolerance (P≤.05).

Impaired glucose tolerance was also associated with lower glucose-derived breath ¹³CO₂ from one to 3.5 hours after glucose compared with normal glucose tolerance (P≤.05). One to three hours after the oral glucose load was the optimal time for breath collection, according to the researchers.

“The breath analyzer was capable of detecting marked differences in glucose-derived breath CO₂ kinetics between individuals with normal glucose tolerance and prediabetes/early-stage diabetes within 60 minutes of a 10-hour OGTT,” they wrote.

Individuals with prediabetes and early-stage diabetes had peak breath ¹³CO₂ abundance at 4.5 hours compared with 3.5 hours for individuals with normal glucose tolerance (36.87 vs. 41.36).

These findings correlated with differences in glucose kinetics between the two groups. A breath test may be an alternative option for recognition of prediabetes or early-stage diabetes in at-risk individuals without the need for blood sampling, according to the researchers.

Dillon EL. Diabetes Care. 2009;32:430-435.

The diagnosis of diabetes with breath testing is totally unnecessary and an unwarranted added expense, especially since a diagnosis of diabetes only requires one blood drawing.

– David S. H. Bell, MD

Endocrine Today Editorial Board member