ความสัมพันธ์ระหว่างระดับน้ำตาลจากลมหายใจกับระดับน้ำตาลในเลือดของกลุ่มผู้เป็นเบาหวานและไม่เป็นเบาหวานที่มารับบริการในโรงพยาบาลเลิดสิน

Tanapon Diewtragoonchai; Thitinun  Anusornvongchai

Authors

Tanapon Diewtragoonchai Department of Internal Medicine, Lerdsin Hospital
Thitinun Anusornvongchai Department of Internal Medicine, Lerdsin Hospital

Keywords:

Breath glucose level, Blood sugar level, Diabetic patient, VAYU Breathology G-300

Abstract

Background: The standard glucose measurement is venous or capillary blood, which may cause pain or bruising at the puncture site. Our research aims to study the accuracy of breath glucose levels compared to blood glucose levels in order to develop a new approach to measuring glucose which convenient, painless, and effective. Objective: To study the relationship between breath glucose levels, compared to blood glucose levels in both diabetic and non-diabetic populations. Method: The analytical cross-sectional correlational study that compared the venous blood glucose level with the breath glucose levels, using the VAYU Breathology G-300. The analysis of correlation and consistency of the instruments use Intraclass correlation (ICC) statistics and Bland-Altman plot, statistically significant at p-value < .05. Result: The total 71 participants of diabetic and non-diabetic patients in Lerdsin Hospital. The results revealed the average breath glucose level was lower than blood glucose level by 1.23 mg/dL, which was not statistically significant (p = .185) and no difference in either diabetic and non-diabetic group (1.31 mg/dL and 1.12 mg/dL, p =.366 and p = .264, respectively), except for diabetic patient who aged 60-69 years or high HbA1c (> 8.0%). However, the interclass correlation coefficient (ICC) analysis of the relationship between the results was very high in all groups (ICC > 0.9, p < .001), indicating a very good consistency and the Bland-Altman plot analysis also showed that the differences were within the acceptable range. Conclusion: The breath glucose levels had a high correlation with blood glucose levels and no statistically significant difference. The breath glucose measurement has potential and may be served as an alternative to glucose testing. However, further studies are needed to confirm its accuracy and efficiency of clinical implementation.

References

Havas S Educational guidelines for achieving tight control and minimizing complications of type 1 diabetes. Am Fam Physician 1999;60(7):1985-92,1997-8.

Burge MR. Lack of compliance with home blood glucose monitoring predicts hospitalization in diabetes. Diabetes Care 2001;24(8):1502-3.

McNichols RJ, Coté GL. Optical glucose sensing in biological ﬂuids: an overview. J Biomed Opt 2000;5(1):5-16.

Gupta S, Sandhu SV, Bansal H, Sharma D. Comparison of salivary and serum glucose levels in diabetic patients. J Diabetes Sci Technol 2015;9(1):91-6.

Roberts K, Jaffe A, Verge C, Thomas PS. Noninvasive monitoring of glucose levels: is exhaled breath the answer? J Diabetes Sci Technol 2012;6(3):659-64.

Vaddiraju S, Burgess DJ, Tomazos I, Jain FC, Papadimitrakopoulos F. Technologies for continuous glucose monitoring: current problems and future promises. J Diabetes Sci Technol. 2010;4(6):1540-62.

Beduk T, Durmus C, Hanoglu SB, Beduk D, Salama KN, Goksel T, et al. Breath as the mirror of our body is the answer really blowing in the wind?: Recent technologies in exhaled breath analysis systems as non-invasive sensing platforms. TrAC 2021;143.

Smith D, Spaněl P, Fryer AA, Hanna F, Ferns GA. Can volatile compounds in exhaled breath be used to monitor control in diabetes mellitus? J Breath Res 2011;5(2):022001.

Smith D, Spanel P, Davies S. Trace gases in breath of healthy volunteers when fasting and after a protein-calorie meal: a preliminary study. J Appl Physiol (1985) 1999;87(5):1584-8.

Greiter MB, Keck L, Siegmund T, Hoeschen C, Oeh U, Paretzke HG. Differences in exhaled gas profiles between patients with type 2 diabetes and healthy controls. Diabetes Technol Ther 2010;12(6):455-63.

Guo D, Zhang D, Zhang L, Lu G. Non-invasive blood glucose monitoring for diabetics by means of breath signal analysis. Sensors and Actuators B Chemical 2012;173:106-13.

assopoulos CN, Barnett D, Fraser TR. Breath-acetone and blood-sugar measurements in diabetes. Lancet 1969;1(7609):1282-6.

Blaikie TP, Edge JA, Hancock G, Lunn D, Megson C, Peverall R, et al. Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes. J Breath Res 2014;8(4):046010.

Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.