Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Mar;32(3):430-5.
doi: 10.2337/dc08-1578. Epub 2008 Dec 15.

Novel noninvasive breath test method for screening individuals at risk for diabetes

E Lichar Dillon  1 , Morteza Janghorbani, James A Angel, Shanon L Casperson, James J Grady, Randall J Urban, Elena Volpi, Melinda Sheffield-Moore
Affiliations

Novel noninvasive breath test method for screening individuals at risk for diabetes

E Lichar Dillon et al. Diabetes Care. 2009 Mar.

Abstract

Objective: Diagnosis of pre-diabetes and early-stage diabetes occurs primarily by means of an oral glucose tolerance test (OGTT), which requires invasive blood sampling. The aim of this study was to determine whether differences exist in breath (13)CO(2) excretion during a (13)C-labeled OGTT between individuals with normal glucose tolerance (NGT) and individuals with pre-diabetes and early-stage diabetes (PDED) and whether these differences correlated with blood glucose kinetics.

Research design and methods: Blood and breath samples were collected at baseline and every 30 min for a 10-h period after ingestion of 75 g glucose isotopically labeled with 150 mg [U-(13)C(6)]D-glucose.

Results: Age (56 +/- 5 vs. 47 +/- 3 years) and BMI (31 +/- 2 vs. 31 +/- 2 kg/m(2)) were not different between individuals with NGT (n = 10) and PDED (n = 7), respectively. Blood glucose concentrations were significantly higher in those with PDED compared with those with NGT from baseline to 4.5 h after glucose ingestion (P <or= 0.05). Glucose-derived breath (13)CO(2) was significantly lower in individuals with PDED compared with those with NGT from 1 to 3.5 h after glucose (P <or= 0.05). Peak breath (13)CO(2) abundance occurred at 4.5 and 3.5 h in individuals with PDED and NGT, respectively (36.87 +/- 3.15 vs. 41.36 +/- 1.56 per thousand delta over baseline).

Conclusions: These results suggest that this novel breath test method may assist in recognition of pre-diabetes or early-stage diabetes in at-risk persons without the need for invasive blood sampling, thus making it an attractive option for large-scale testing of at-risk populations, such as children.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study time line. Subjects followed a 3-day standardized low-carbohydrate diet composed of 15% carbohydrate, 25% protein, and 60% fat. Individual dietary requirements were determined by a registered dietitian and calculated using the Harris Benedict equation. On the fourth day, after an overnight fast, a 10-h stable isotopically labeled OGTT was performed, and blood and breath samples were collected every 30 min.
Figure 2
Figure 2
Blood glucose and plasma insulin concentrations in individuals with NGT and PDED during the 10-h OGTT. A: Blood glucose was different between individuals with NGT and PDED over time as determined by mixed-model repeated measures (P < 0.05). *Different between individuals with NGT and PDED (t test, P < 0.05). B: Plasma insulin was different between individuals with NGT and PDED over time as determined by mixed-model repeated measures (P < 0.05). *Different between individuals with NGT and PDED (t test, P < 0.05).
Figure 3
Figure 3
Breath 13CO2 abundance and areas under the curve for individuals with NGT and PDED during the 10-h OGTT. A: Breath 13CO2 abundance was different between individuals with NGT and PDED over time as determined by mixed-model repeated measures (P < 0.05). *Significant difference between individuals with NGT and PDED (t test, P < 0.05). B: AUCs were different between individuals with NGT and PDED when measured from 0 to 4 h but not when measured from 0 to 10 h. *Significant difference between individuals with NGT and PDED (t test, P < 0.05).
See this image and copyright information in PMC

Comment in

References

    1. Hegarty BD, Furler SM, Ye J, Cooney GJ, Kraegen EW: The role of intramuscular lipid in insulin resistance. Acta Physiol Scand 178:373–383, 2003 - PubMed
    1. Reaven GM: insulin resistance/compensatory hyperinsulinemia, essential hypertension, and cardiovascular disease. J Clin Endocrinol Metab 88:2399–2403, 2003 - PubMed
    1. Hanley AJ, Festa A, D'Agostino RB Jr, Wagenknecht LE, Savage PJ, Tracy RP, Saad MF, Haffner SM: Metabolic and inflammation variable clusters and prediction of type 2 diabetes: factor analysis using directly measured insulin sensitivity. Diabetes 53:1773–1781, 2004 - PubMed
    1. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716, 2002 - PubMed
    1. Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ, Pio JR, Williams GR: Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 110:1245–1250, 2004 - PubMed

Publication types