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Breath test could improve type 1 diabetes diagnoses, management in children
Diagnosing type 1 diabetes in children, and managing their condition, before the onset of serious illness could be achieved through the use of a noninvasive breath test, according to research published in the Journal of Breath Research.
Through an investigation of relationships between breath gases and blood glucose and blood ketone levels, researchers in the United Kingdom demonstrated a link between a sweet-smelling marker and buildup of chemicals in blood that can result from low insulin levels.
“Our results have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones in children and young people with well controlled type 1 diabetes,” Gus Hancock, PhD, of the University of Oxford, told Endocrine Today. “While breath acetone has been measured in relatively large cohorts of healthy individuals, most measurements on people with type 1 diabetes have been carried out on relatively small cohorts, typically made up of less than 20 people, with relatively few measurements on children.”
Gus Hancock
Hancock, along with Julie Edge, MD, of Oxford Children’s Hospital, and colleagues from the UK-based company Oxford Medical diagnostics, collected gases in breath bags from 54 girls and 59 boys with type 1 diabetes aged 8 to 18 years during a routine visit; the measurements were compared with capillary blood glucose and ketone levels gathered at the same time.
The patients had relatively low concentrations of the blood ketone beta-hydroxybutyrate (0-0.4 mmol/L−1); breath acetone levels rose along with blood beta-hydroxybutyrate levels (P<10-4). A positive but weak relationship was observed between blood glucose and breath acetone (P=.1); this led the researchers to conclude single acetone measurements did not offer solid blood glucose measurements in the group. No link was demonstrated between isoprene and acetone levels in breath and glucose levels in the blood.
The researchers have now developed a hand-held device to measure acetone levels in the breath, Hancock said. This may help identify children with new diabetes prior to diabetic ketoacidosis, he added.
“If as expected we find the tracking of blood ketones and breath acetone in patients with type 1 diabetes at higher levels than those found in the present study, it could act as a screening tool; high acetone levels will indicate that further tests are necessary,” Hancock said.
“Also, a simple breath test carried out at home could assist with the management of sick days in children with diabetes, preventing hospital admissions by providing a warning of the possible development of diabetic ketoacidosis.” – by Allegra Tiver
Gus Hancock, PhD, can be reached at the Department of Chemistry, University of Oxford, Physical and Theoretical Chemistry Laboratory, South Parks Road, Oxford OX1 3QZ, UK; email: gus.hancock@chem.ox.ac.uk.
Disclosure: The study was funded by the Department of Chemistry, University of Oxford. Some researchers report relationships with Oxford Medical Diagnostics, where the analysis of breath gases took place.