New Ways to Detect Diabetes Earlier
What if there was a way to detect the possibility of developing diabetes in young people decades before it numbed the nerves in their feet, clogged their arteries, stole their vision and shut down their kidneys?
In the past, urine sugar tests and fasting blood tests have been used as primary methods of screening for diabetes. Low in sensitivity, however, the tests often give negative results to those who have early diabetes. The glucose tolerance test is more accurate for diabetes diagnosis, but can be painful and troublesome. Blood hemoglobin and fructosamine tests are considered unreliable in the case of light diabetes.
All those who have a family history of diabetes or are obese need to find out if they have a chance of developing diabetes or not. Women with gestational diabetes should be watched closely after giving birth and at regular intervals to detect diabetes early. Up to 40% of women with gestational diabetes develop full-blown diabetes within 5-10 years after delivery. The risk may be increased in obese women. A one-hour post prandial (PRAN-de-il) blood sugar test is valuable screening test used to detect diabetes in pregnancy.
The prevalence of type 2 diabetes mellitus (diabetes) in the United States is growing; the burden of suffering caused by its complications is heavy and may also be growing but almost half of them remain undiagnosed. In Type 1 diabetes, the pancreas fails to produce insulin for the body due to cell damage. These complications include increased risk of cardiovascular disease (CVD) or event (e.g., myocardial infarction [MI], stroke, heart failure, or sudden death), ESRD, blindness, and amputation of the lower extremities.
For a person who is a first-degree relative of a patient with type 1 diabetes and who has antibodies to islet antigens, such as insulin, glutamate decarboxylase (GAD65), or tyrosine phosphatase–like protein (IA-2), the risk of diabetes increases with the number of antibodies.4 However, diabetes does not develop in most antibody-positive relatives; in long-term prospective studies, many such relatives have remained normoglycemic despite the presence of both islet-cell antibodies and a reduced ability to secrete insulin.
Going to an eye specialist — an ophthalmologist or an optometrist — annually will help detect diabetes-related vision problems and catch them early, when they're treatable. If you have poorly controlled diabetes, high blood pressure, kidney disease or elevated cholesterol, you may need to see your eye specialist more than once a year. Chronic condition such as diabetes can interfere with the development of the fetus's heart. You can reduce or eliminate the risk by carefully controlling your diabetes before attempting to conceive and during pregnancy.
To evaluate the feasibility of other, potentially more cost-effective screening techniques, Edelman and his colleagues of the Durham Veterans’ Affairs Medical Center and Duke University Medical Center selected a test (HgA1c) that accurately indicates blood sugar levels over the previous two to three months and can detect at least 75 percent of cases of diabetes, but does not require fasting.
Other study findings indicate this new screening technique would detect almost as many cases of undiagnosed diabetes if performed only on patients with one or more of three risk factors: obesity, self-reported high blood pressure and family history of the disease. Such targeting would make the screening even more cost-effective.
- Another study concluded that microalbuminuria (30 to 140 micrograms of albumin per milliliter) would predict the later development of increased proteinuria and early mortality in Type II diabetics.
- Two Mississippi State scientists have invented a high-tech sensory device that can detect the early symptoms of diabetes in a person's breath. You blow your breath into the instrument one time and you receive a number indicating your status, whether you are diabetes-free or in the early or severe stages of the disease. They now are seeking a commercial partner to help them move their unique diabetes breath analyzer from the university laboratory into the marketplace.
- HbA1c level is considered an important monitoring tool in treating patients with diabetes, but it is not currently recommended for screening or for the diagnosis of diabetes. But according to the results of a study from Yale University School of Medicine in Derby, Connecticut, and colleagues suggested that the role of HbA1c level for diabetes case finding in hospitalized patients with hyperglycemia.... This situation may provide a golden opportunity to locate, educate, and begin treating the large number of undiagnosed patients with diabetes.
They given evidence and said "In acutely ill patients with random hyperglycemia at hospital admission, an HbA1c) level greater than 6.0% reliably diagnoses diabetes, and an HbA1c level less than 5.2% reliably excludes it (paralleling the operating characteristics of the standard fasting glucose measurements)".
- Tissue optical information of an individual, including at least a measurement of at least one wavelength or group of wavelengths by spectroscopic analysis method of human tissue to classify an individual as diabetic or non-diabetic, or to determine the probability, progression or level of diabetes in an individual.
This indicative of glycosylated collagen content in tissue, is analyzed using multivariate techniques. The multivariate techniques include an algorithm developed from optical information from individuals having a known disease state. At least one factor in the algorithm is dependent on or a function of the measurement of the at least one wavelength or group of wavelengths indicative of glycosylated collagen content in tissue from the optical information of individuals forming the database.
- Detection of an autoimmune response to components of the islet cells, such as glutamic acid decarboxylase, proinsulin, and ICA512, is predictive of the future development of diabetes. Monash University researchers are investigating the structure of proteins present in the pancreas to gain a better understanding of how Type 1 diabetes develops. They hope the research will lead to the development of a test kit for earlier detection of the disease.
- Type II diabetes particularly afflicts obese individuals. Numerous genes and environmental factors, like sedentary lifestyle, interact to produce a predisposition for diabetes (diabesity), making it difficult to tease out individual suspects. According to a Genome Research shown that an animal's 'maternal environment' acts together with genetics to increase the risk of obesity and obesity-related diabetes.
- Joslin Diabetes Center and Massachusetts General Hospital (MGH) researchers used a new imaging technique to reveal the otherwise undetectable inflammation of pancreatic islets in recently diagnosed diabetic mice. As T lymphocytes invade the pancreas, blood vessels swell, become more permeable, and leak fluid -- as well as small molecules carried in the fluid -- into surrounding tissues. In previous experiments, the researchers demonstrated that this leakage can be detected with the help of magnetic nanoparticles (MNP) and magnetic resonance imaging (MRI).The MNPs become concentrated at the inflamed site and can be spotted by high-resolution MRI.
They said ;"the most exciting aspect of this study is that it demonstrates that we can, at least in mice, use a non-invasive imaging method to predict at a very early time whether a drug will stop the progression of diabetes or not and may be helpful in identifying people at immediate risk of developing autoimmune diabetes".
- Researchers at the Barbara Davis Center for Childhood Diabetes and University of Colorado at Denver and Health Sciences Center's School of Medicine have discovered a fourth antibody in human blood which will help more accurately predict who is predisposed to type 1 diabetes.
- Mayo Clinic researchers have found that subtle change in nerve conduction is the first reliable sign of nerve complications from diabetes and that this change can be measured long before other symptoms or signs of nerve damage develop. In the study, researchers used various techniques to measure nerve changes, including patient exams, reflex and strength tests, and nerve conduction tests, which measure how quickly nerves carry electrical signals. The nerve conduction tests, over time, provided the most consistent and reliable measures of early nerve damage due to diabetes.
Three antibodies are routinely measured giving a 90 percent chance of predicting disease. With the discovery of this fourth autoantibody, ZnT8, the prediction rate jumps to 96 percent. This fourth auto antigen will find immediate use in identifying individuals with a family history of diabetes or a genetic predisposition to the disease for recruitment into clinical trials aimed at preventing diabetes.
- Pakistan Medical Research Council (PMRC) has developed a diagnostic kit for detection of albumin in the urine of diabetics at a very early stage. Albumin in diabetics leads to kidney failure and its early detection can be preventive in this regard. The kit has been developed by the PMRC Centre at Shaikh Zayed Hospital and after being checked in UK it is now available for marketing.
- Researchers in America may have developed a new tool that could make it possible to detect diabetes on the breath of type 1 diabetics .Using an injection of acetone-laden water vapor into a small chamber with mirrors, the team sent an infrared laser beam sensitive to acetone into the chamber. By detecting the amount of time it takes for the light to dissolve, they can perceive the volume of acetone concentrations. According to initial tests, diabetics have higher acetone levels than non-diabetics. If the technique could be extended to test daily blood-sugar levels, then it would be "extremely interesting.
- Measuring patients' glycosylated hemoglobin levels (A1C) could be used to screen for diabetes, according to California based researchers recently suggested.A1C measurements do not require fasting and can be measured at a routine office visit.
- "This should increase the early diagnosis of diabetes so that appropriate treatment can be instituted to prevent the complications of the disease," they concluded.
A1C is a test that measures the percentage of glucose (sugar) that is attached to hemoglobin, a molecule in red blood cells. It reflects the average glucose levels over the previous 3 to 4 months. Untreated (or uncontrolled) diabetics have A1C levels that are 7.0 percent or higher. Diabetes is also detected by fasting plasma glucose levels of 126 milligrams per deciliter (mg/dL) or greater.
Women with a history of gestational diabetes should use effective contraception to minimize the chance that they will become pregnant with untreated hyperglycemia, which increases the risk of birth defects in their infants. Long-term treatment with low-dose combination oral contraceptives does not appear to increase the risk of diabetes after gestational diabetes.
Early detection by screening could allow clinicians to offer a variety of interventions during the preclinical period, including tight glycemic control; more intensive use and targeted choice of antihypertensive agents; more aggressive use of lipid treatment and aspirin; institution of foot care programs; and counseling for dietary change, physical activity, and smoking cessation. Direct evidence shows that many of these interventions improve health outcomes when initiated after clinical diagnosis. The magnitude of added benefit to initiating them earlier, during the preclinical period, however, must be extrapolated from indirect evidence.
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