A chemical that is found in our breath could provide a flag to warn of dangerously low blood sugar levels in
patients with type 1 diabetes, according to new research the
University of Cambridge. The finding, published in the journal
Diabetes Care, could explain why some dogs can be trained to spot the
warning signs in patients.
Important terminology - Volatile
organic compounds (VOCs) – term used in Diabetes Care report.
Claire Pesterfield, a pediatric
diabetes specialist nurse at Addenbrooke's Hospital, Cambridge
University Hospitals NHS Foundation Trust has type 1 diabetes, which
requires insulin injections to manage blood sugar levels. She also
has a golden Labrador dog that has been trained by the charity
Medical Detection Dogs to detect when her blood sugar levels are
falling to potentially dangerous levels.
Claire had a diabetes service dog and
she says her golden Labrador alerts her when she is at risk for
hypoglycemia. She says he jumps up and puts his paws on her
shoulders to let her know.
Hypoglycemia (low blood glucose) can
cause problems such as shakiness, disorientation and fatigue; if the
patient does not receive a sugar boost in time, it can cause seizures
and lead to unconsciousness. In some people with diabetes, these
episodes can occur suddenly with little warning.
Given the reports of dogs alerting
owners to blood glucose changes, researchers at the Wellcome
Trust-MRC Institute of Metabolic Science, University of Cambridge,
believed that certain naturally occurring chemicals in exhaled breath
might change when glucose levels were low. In a preliminary study to
test this hypothesis, the scientists gradually lowered blood sugar
levels under controlled conditions in 8 women, all around their
forties, and all with type 1 diabetes. They then used mass
spectrometry, which look for chemical signatures, to detect the
presence of these chemicals.
The researchers found that levels of
the chemical isoprene rose significantly at hypoglycemia, in some
cases almost doubling. They believe that dogs may be sensitive to
the presence of isoprene, and suggest that it may be possible to
develop new detectors that can identify elevated levels of isoprene
in patients at risk.
Another group in Ireland had also tried
to discover what the dogs were smelling, but had no success. In the
USA, several companies have researched this and have been left
wanting.
"Isoprene is one of the most
common natural chemicals that we find in human breath, but we know
surprisingly little about where it comes from," says Dr Mark
Evans, Honorary Consultant Physician at Addenbrooke's Hospital,
University of Cambridge. "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 glucose.”
"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. It 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."
The research was funded by the National
Institute for Health Research (NIHR) Cambridge Biomedical Research
Centre with support from the Cambridge NIHR Wellcome Trust Clinical
Research Facility.
The one thing not mentioned in all the
articles or Diabetes Care, it that this has been proven to be what
the dogs smell. It all sounds good, but no positive statement has
been made saying a discovery has been made. This may be what they
are looking for, but I will wait until an actual piece of equipment
is available and working.
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