Screening for Diabetes Without a Needle-Stick

Robert W. Griffith, MD

Many years ago diabetes was diagnosed by testing the urine for sugar. This was pretty crude - many people with the disease would be missed by this method. Then came the era of the glucose tolerance test: a fasting blood sugar and repeat sampling at 30', 1 h, 90' and 2 h after taking a glucose drink. Then the HbA1c came into fashion. Still a blood test, and not really used for screening, but an advance over a regular blood sugar level - and you didn't need to fast.

Now there's a new screening tool - and it's noninvasive, meaning the skin isn't penetrated. A report in Diabetes Care describes the technique and the results obtained using the special spectroscope. The instrument measures the amount of advanced glycation end products (AGEs) in the skin. AGEs are sugar-derived substances; their formation is markedly accelerated in diabetes because of the increased availability of glucose.

In a study to establish the usefulness of skin AGE measurement, scientists compared results from fasting plasma glucose, HbA1c, and skin AGE taken from 350 subjects. Those with a 2-hour oral glucose tolerance value of 140 mg/dL or above were classified as having diabetes. The sensitivity and the specificity of skin AGE measurement were superior to the fast glucose and HbA1c determinations; the noninvasive method was capable of detecting 29% and 17% more of the classified diabetics than the fasting plasma glucose and the HbA1c, respectively. All this without a needle stick and within a matter of minutes - a great new screening instrument. Now it has to get FDA approval - who knows how long that will take.

Source
HealthandAge Blog

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