Non invasive screening for DM

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http://www.medscape.com/viewarticle/555989


"May 3, 2007 — Spectroscopic measurement of dermal advanced glycation
end products (AGEs) is a more effective and noninvasive technology for
prediabetes and diabetes screening compared with fasting plasma glucose
and glycated hemoglobin (A1c) tests, according to the results of a study
published in the May issue of Diabetes Care.

"This study compared the performance of a novel noninvasive technology
to fasting plasma glucose (FPG) and A1C tests for detecting undiagnosed
diabetes and impaired glucose tolerance," write John D. Maynard, MS,
from VeraLight in Albuquerque, New Mexico, and colleagues. "Current
screening methods for type 2 diabetes and pre-diabetes are inadequate
due to their inconvenience and inaccuracy.... A more accurate and
convenient screening method could dramatically improve early detection
of type 2 diabetes and its precursors, facilitating interventions that
can prevent or at least delay the development of type 2 diabetes and its
related micro- and macrovascular complications."

Elevated skin AGEs are biomarkers of diabetes, are highly correlated
with the complications of diabetes, and predict future diabetic
retinopathy and nephropathy. Individuals with diabetes accumulate skin
AGEs faster than do individuals with normal glucose regulation. Until
the recent development of novel noninvasive technology to measure AGEs,
a punch biopsy was needed to quantify skin AGE levels. Spectroscopic
measurement of dermal AGEs (SAGE) measures skin fluorescence caused by
AGEs and provides a quantitative diabetes risk score. It does not
require fasting, creates no biohazards, automatically compensates for
subject-specific skin differences, and provides an immediate result.

This head-to-head evaluation in a naive population of 351 subjects
compared results from FPG and A1C tests with results from testing with a
noninvasive device that detects the fluorescence of skin AGEs."

Susan I read about this yesterday and thought it was very interesting.
I am taking a wait and see attitude. It will be nine months before it
is approved. I read there is an 85% accuracy rate . That doesnt seem
high enough for me.

Maybe all meters are 85% accurate, but I dont know it.

Loretta

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Loretta Eisenberg wrote:
> Susan I read about this yesterday and thought it was very interesting.
> I am taking a wait and see attitude. It will be nine months before it
> is approved. I read there is an 85% accuracy rate . That doesnt seem
> high enough for me.
>
> Maybe all meters are 85% accurate, but I dont know it.

Loretta, fbg is only 30% accurate in women and 52% accurate in men and
that's the standard being promulgated by the ADA for DM screening in
routine blood work.

It will be interesting to see how AGEs compare to post prandial
numbers, so far the most reliable DM screening method, and the cheapest.

Susanj

sassybklynlady@webtv.net (Loretta Eisenberg) wrote in part:

>Susan I read about this yesterday and thought it was very interesting.
>I am taking a wait and see attitude. It will be nine months before it
>is approved. I read there is an 85% accuracy rate . That doesnt seem
>high enough for me.
>
>Maybe all meters are 85% accurate, but I dont know it.
>
>Loretta

This isn't related to the non-invasive bg meter discussed before. It is a
method of getting a fix on a kind of glycation different from that measured
by A1c. It wouldn't substitute for measures of bg.

What I found most interesting was the very high % of diabetics and
pre-diabetics in a supposedly healthy sample of "non-diabetics" of all adult
ages. 24%, if I recall correctly. Wow.
--
Jim Chinnis Warrenton, Virginia, USA

Loretta Eisenberg <sassybklynlady@webtv.net> wrote:
: Susan I read about this yesterday and thought it was very interesting.
: I am taking a wait and see attitude. It will be nine months before it
: is approved. I read there is an 85% accuracy rate . That doesnt seem
: high enough for me.

: Maybe all meters are 85% accurate, but I dont know it.

: Loretta

I read about this too. What are AGES?

Wendy

Jim Chinnis <jchinnis@spamalum.mit.edu> wrote:
> sassybklynlady@webtv.net (Loretta Eisenberg) wrote in part:

>>Susan I read about this yesterday and thought it was very interesting.
>>I am taking a wait and see attitude. It will be nine months before it
>>is approved. I read there is an 85% accuracy rate . That doesnt seem
>>high enough for me.
>>
>>Maybe all meters are 85% accurate, but I dont know it.
>>
>>Loretta

> This isn't related to the non-invasive bg meter discussed before. It is a
> method of getting a fix on a kind of glycation different from that measured
> by A1c. It wouldn't substitute for measures of bg.

> What I found most interesting was the very high % of diabetics and
> pre-diabetics in a supposedly healthy sample of "non-diabetics" of all adult
> ages. 24%, if I recall correctly. Wow.

That's why I don't trust those naive studies which simply take a bunch
of non-diabetics and track their pp BGs and say "Oh, look, big BG
excursions! That means it's normal to have big pp BG excursions." :-)

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

W. Baker <wbaker@panix.com> wrote:
> Loretta Eisenberg <sassybklynlady@webtv.net> wrote:
> : Susan I read about this yesterday and thought it was very interesting.
> : I am taking a wait and see attitude. It will be nine months before it
> : is approved. I read there is an 85% accuracy rate . That doesnt seem
> : high enough for me.

> : Maybe all meters are 85% accurate, but I dont know it.

> : Loretta

> I read about this too. What are AGES?

Advanced Glycation Endproducts. A1C tests for one of these, the one
which is found in the red blood cells.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Chris Malcolm <cam@holyrood.ed.ac.uk> wrote:
: W. Baker <wbaker@panix.com> wrote:
: > Loretta Eisenberg <sassybklynlady@webtv.net> wrote:
: > : Susan I read about this yesterday and thought it was very interesting.
: > : I am taking a wait and see attitude. It will be nine months before it
: > : is approved. I read there is an 85% accuracy rate . That doesnt seem
: > : high enough for me.

: > : Maybe all meters are 85% accurate, but I dont know it.

: > : Loretta

: > I read about this too. What are AGES?

: Advanced Glycation Endproducts. A1C tests for one of these, the one
: which is found in the red blood cells.

: --
: Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
: IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
: [http://www.dai.ed.ac.uk/homes/cam/]

Thanks, so the ones they are testing for are somewhere on the skin?

Wendy

W. Baker <wbaker@panix.com> wrote:
> Chris Malcolm <cam@holyrood.ed.ac.uk> wrote:
> : W. Baker <wbaker@panix.com> wrote:
> : > Loretta Eisenberg <sassybklynlady@webtv.net> wrote:
> : > : Susan I read about this yesterday and thought it was very interesting.
> : > : I am taking a wait and see attitude. It will be nine months before it
> : > : is approved. I read there is an 85% accuracy rate . That doesnt seem
> : > : high enough for me.

> : > : Maybe all meters are 85% accurate, but I dont know it.

> : > : Loretta

> : > I read about this too. What are AGES?

> : Advanced Glycation Endproducts. A1C tests for one of these, the one
> : which is found in the red blood cells.

> : --
> : Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
> : IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
> : [http://www.dai.ed.ac.uk/homes/cam/]

> Thanks, so the ones they are testing for are somewhere on the skin?

Under the skin in the living tissues -- infrared penetrates quite some
way under the skin.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]