title: Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes.
abstract: Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (β hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood β hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation ρ = 0.364, p < 10(-4)). A weak positive relationship was found between blood glucose and breath acetone (ρ = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.
authors.affiliation: Centre for Innovation and Enterprise, Oxford Medical Diagnostics Ltd, Begbroke Science Park, Begbroke Hill, Begbroke OX5 1PF, UK.
authors.forename: Tom P J
authors.initials: TP
authors.lastname: Blaikie
authors.forename: Julie A
authors.initials: JA
authors.lastname: Edge
authors.forename: Gus
authors.initials: G
authors.lastname: Hancock
authors.forename: Daniel
authors.initials: D
authors.lastname: Lunn
authors.forename: Clare
authors.initials: C
authors.lastname: Megson
authors.forename: Rob
authors.initials: R
authors.lastname: Peverall
authors.forename: Graham
authors.initials: G
authors.lastname: Richmond
authors.forename: Grant A D
authors.initials: GA
authors.lastname: Ritchie
authors.forename: David
authors.initials: D
authors.lastname: Taylor
mesh_terms: D000096:Acetone / Q000032:analysis* / Q000097:blood*; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001944:Breath Tests; D002070:Butadienes / Q000097:blood; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000378:metabolism*; D005260:Female; D005740:Gases / Q000032:analysis* / Q000097:blood*; D045782:Hemiterpenes / Q000097:blood; D006801:Humans; D008297:Male; D010420:Pentanes / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002070:Butadienes; D005740:Gases; D045782:Hemiterpenes; D010420:Pentanes; C005059:isoprene; D000096:Acetone