title: Non-invasive screening of diabetes risk by assessing abnormalities of sudomotor function.
abstract: BACKGROUND
  The early detection of diabetes, and subsequent lifestyle intervention, may reduce the burden of diabetes and its complications. Several studies have identified a link between sudomotor dysfunction, insulin resistance, and pre-diabetes. The aim of this study was to evaluate the ability of a new non-invasive device EZSCAN evaluating sudomotor function to detect pre-diabetes in a German population at risk for diabetes.
  
  
  RESULTS
  200 German subjects at risk for diabetes (mean age 56±14 years, BMI 28.4±5.4 kg/m2) were measured for anthropometric data on inflammatory parameters, including high sensitivity C reactive protein (hs-CRP). The subjects also underwent an oral glucose tolerance test with measurements of plasma glucose, insulin, proinsulin, C-peptide and free fatty acids during 2 h following glucose challenge. Indexes for sensitivity to insulin were calculated: SI using minimal model, HOMA-IR and Matsuda index. Based on the measurement of electrochemical sweat conductance, subjects were classified as no risk, moderate risk or high risk. According to this risk model classification, a significant difference was observed between OGTT-1 h (p=0.004), AUC glucose (p=0.011), AUC C-peptide (p<0.001), HOMA-IR (p=0.009), Matsuda (p=0.002), SI (p<0.001) and hs-CRP (p=0.025) after adjustment for age. Among the 54 subjects with impaired fasting glucose or impaired glucose tolerance according to WHO classification, 37 had a moderate risk and 15 a high risk according to the EZSCAN risk model classification. Among the 12 subjects with newly diagnosed diabetes, 2 had a moderate risk and 10 a high risk according to the risk model classification. No adverse event was reported during or after the study.
  
  
  CONCLUSIONS
  These results, in accordance with a previous study performed in India, show that EZSCAN could be developed as a screening tool for diabetes risk, and could help to improve diabetes screening strategies. Results obtained from an at-risk population would have to be confirmed in a larger population.
authors.affiliation: University Clinic Carl Gustav Carus at the Technical University Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Müller
authors.affiliation: University Clinic Carl Gustav Carus at the Technical University Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Olschewski
authors.affiliation: University Clinic Carl Gustav Carus at the Technical University Dresden, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Stange
authors.affiliation: University of Oslo, Institute of General Practice and Community Medicine, Department of Preventive Medicine and -Epidemiology, Oslo, Norway.
authors.forename: V T
authors.initials: VT
authors.lastname: Hjellset
authors.affiliation: University Clinic Carl Gustav Carus at the Technical University Dresden, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Bornstein
authors.affiliation: University Clinic Carl Gustav Carus at the Technical University Dresden, Germany.
authors.forename: P E H
authors.initials: PE
authors.lastname: Schwarz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011384:Proinsulin / Q000097:blood; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D002097:C-Reactive Protein; D011384:Proinsulin