Isoprene breath test could replace blood glucose tests for hypo detection

Benedict Jephcote
Wed, 29 Jun 2016
Isoprene breath test could replace blood glucose tests for hypo detection
A breath test to detect the presence of hypoglycemia could represent an improvement on current finger-prick blood glucose tests, following a scientific breakthrough.

The breath of eight women with type 1 diabetes were studied by a team at the University of Cambridge and the findings were published in the journal Diabetes Care.

The team used controlled conditions to gradually lower the participants’ blood sugar levels and discovered high levels of isoprene in those who were experiencing a hypoglycemic episode.

Dr Mark Evans, honorary consultant physician at Addenbrooke's Hospital, University of Cambridge, said: "[Isoprene] provides a 'scent' that could help us develop new tests for detecting hypoglycemia and reducing the risk of potentially life-threatening complications for patients living with diabetes.

"It’s our vision that a new breath test could at least partly - but ideally completely - replace the current finger-prick test, which is inconvenient and painful for patients, and relatively expensive to administer."

Currently, finger-prick tests are necessary to check whether a hypoglycemic episode is occurring. Furthermore, additional finger-prick checks are required at 15 minute intervals after hypo treatment to check whether blood glucose levels have returned to normal.

If a reliable isoprene breath test is developed, it could prevent people with diabetes needing to carry out multiple finger-prick tests in order to sufficiently treat their hypos.

Researchers also think the scent of isoprene could explain why medical detection dogs know blood sugar levels have dropped. Some people with type 1 diabetes have started to use specially trained hypo-alert dogs who are able to detect early warning signs for hypoglycemia.

Dr Evans added: "Isoprene is one of the commonest natural chemicals that we find in human breath, but we know surprisingly little about where it comes from. We suspect it’s a by-product of the production of cholesterol, but it isn’t clear why levels of the chemical rise when patients get very low blood sugar.

"Humans aren’t sensitive to the presence of isoprene, but dogs with their incredible sense of smell, find it easy to identify and can be trained to alert their owners about dangerously low blood sugar levels."

Claire Pesterfield, a paediatric diabetes specialist nurse at Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, has type 1 diabetes.

She also has a golden Labrador dog called Magic, who has been trained by the charity Medical Detection Dogs to detect when her blood sugar levels are falling to potentially dangerous levels.

She said: "Low blood sugar is an everyday threat to me and if it falls too low - which it can do quickly - it can be very dangerous."

"Magic is incredible - he's not just a wonderful companion, but he's my 'nose' to warn me if I'm at risk of a hypo. If he smells a hypo coming, he'll jump up and put his paws on my shoulders to let me know."
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