Similar glycated albumin levels in tears, blood may allow noninvasive glucose testing
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Glycated albumin levels found in the tears of individuals with diabetes strongly correlate with blood levels and suggest a mode for replacing finger stick and other invasive tests, according to study data.
“To achieve strict glucose control preventing diabetic complications, many patients take HbA1c tests in hospitals and some take self-monitoring of blood glucose,” Masakazu Aihara, MD, PhD, a project research associate at the University of Tokyo, told Healio. “Continuous glucose monitoring has also been put into practical use, but all of these measurement methods are invasive, and it is a burden on the patients. We focus on tears, which can be collected with noninvasive ways, and found that the glycated albumin levels in tears and blood had strong correlation. Since glycated albumin reflects 2-week average blood glucose levels, it does not need to be measured as frequently as self-monitoring and can be used in the same way as HbA1c tests.”
Aihara and colleagues presented the findings at the European Association for the Study of Diabetes virtual meeting.
Researchers recruited 100 adults (mean age, 50.87 years; 71% men) with diabetes from outpatient and inpatient practices. Participants had tear samples collected at the same time as a blood sampling tests. Researchers measured glycated albumin levels in tears with liquid chromatography-mass spectrometry, whereas blood sample levels were measured through an enzymatic method.
Glycated albumin levels were appropriately measured in 99 of 100 participants. Initial results showed a correlation between glycated albumin levels in blood and those measured in tears (beta = 0.722; 95% CI, 0.585-0.859). The correlation between tear levels and blood levels remained after adjustments for age, sex, nephropathy stage and obesity (beta = 0.738; 95% CI, 0.594-0.882). HbA1c was not assessed in the study.
“Since tears are easily diluted and concentrated, concentrations such as glucose concentration can easily change,” Aihara said. “On the other hand, glycated albumin is a ratio and does not change even if tears are diluted and concentrated, so we thought that it showed a strong correlation.”
Aihara said the findings demonstrate that glycated albumin is a diabetes-related biomarker and can provide individuals with diabetes a new way to measure glucose levels.
“The correlation of glycated albumin levels in tears and blood that we found in this study was much stronger than that of glucose levels, and a measurement method of tear glycated albumin can be used in clinical practice,” Aihara said. “If the measuring device can be miniaturized, noninvasive glycated albumin measurement at home will be possible, and it is expected to be used for self-medication and remote medical care.”
Researchers plan to optimize measurement conditions, develop tear measuring equipment, and verify the effectiveness and usefulness of the monitoring methods in the future.
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Aihara M, et al. Development of noninvasive diabetes monitoring method using tear samples. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 21-25, 2020 (virtual meeting).
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