Breath Test Could be Boon for Type 1 Diabetes
Imagine taking a simple breath test to identify whether a child has type 1 diabetes or if someone with the disease is developing a potentially life-threatening condition. Researchers in the United Kingdom did more than imagine it; they have discovered a way that may do it.
A scientific team at the University of Oxford, under the direction of Professor Gus Hancock of the Department of Chemistry, has learned that the presence of acetone in the breath may be an early sign of the accumulation of acids called ketones in the blood. Such an accumulation is known as ketoacidosis, and it can cause a diabetic coma or death.
Recognizing diabetic ketoacidosis as early as possible is critical for obvious reasons, and there is another layer to this importance. Research indicates that about 16 percent of cases of new-onset type 1 diabetes are initially misdiagnosed in children. This results in a delay in the correct diagnosis and a great risk that these children will develop diabetic ketoacidosis, perhaps before it is too late.
New study on breath test
In the new study, the investigators evaluated breath and blood samples from 113 young people (ages 7-18 years) who had already been diagnosed with type 1 diabetes. Levels of acetone and isoprene (another ketone) were measured in the breath while glucose and ketone levels were noted in the blood.
The investigators reported that:
- Individuals who had elevated levels of acetone in their breath also had increased levels of beta-hydroxybutyrate, a ketone
- Those who had elevated acetone levels in their breath also had an increased level of glucose in their blood, but the relationship was weak. However, the authors pointed out that taking just one breath measurement of acetone was not sufficient to provide an accurate measurement of glucose levels in the blood in this study.
- No association was seen between levels of acetone and isoprene in the breath and glucose levels in the blood
- A prototype of a device that can measure ketone levels in the breath is being tested in clinical trials at this time
- Overall, Hancock commented that their findings “have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones.”
What all of this could mean, if current and future research progresses as planned, is the availability of a basic breath test that will allow clinicians to detect diabetic ketoacidosis in people with type 1 diabetes before it develops and hopefully a new diagnostic tool to help identify type 1 diabetes much earlier than now possible.
Since about 25 percent of children with type 1 diabetes are not diagnosed until they develop diabetic ketoacidosis, availability of a breath test could be a tremendous boon for such individuals. Currently clinicians use a blood test to identify diabetic ketoacidosis.
What is diabetic ketoacidosis?
Diabetic ketoacidosis is a complication of type 1 diabetes (and sometimes type 2 diabetes) in which the cells are unable to get the glucose necessary for energy. This causes the body to burn fat for energy, and a byproduct of that process is the production of acids called ketones.
Ketones accumulate in the blood and urine, and when their levels are too high, individuals can develop diabetic ketoacidosis. Warning signs and symptoms include frequent urination, high blood glucose levels, severe thirst and/or very dry mouth, fatigue, flushed or dry skin, nausea and/or vomiting, sweet smelling breath, breathing difficulties, and confusion.
American Diabetes Association
Hancock G et al. Comparison of breath gases, including acetone with blood glucose and blood ketones in children and adolescents with type 1 diabetes. Journal of Breath Research 2014 Nov 25 online
Institute of Physics news release accessed via EurekAlert Nov. 27, 2014