Currently Viewing:
Evidence-Based Diabetes Management September 2015
What "Behavioral Change" Looks Like From the Front Lines: Visiting Jefferson Hospital
Mary K. Caffrey
Stumbling Toward Access to Evidence-Based Care for the Chronic Disease of Obesity
Theodore K. Kyle, RPh, MBA: and Fatima Cody Stanford, MD, MPH, MPA
Joslin's Hamdy: Evidence Shows Diet, Exercise Effective Against Diabetes, Obesity Long-Term
Andrew Smith
For Now, PBMs Just Say No to High-Cost PCSK9 Inhibitors
Mary K. Caffrey
From Contrave Saga, Renewed Faith in Trials Built on Trust
Andrew Smith
JAMA: High-Dose Liraglutide Causes Significant Weight Loss in Overweight Persons With T2DM
Mary K. Caffrey
Intarcia Says Phase 3 Results Show Better Control Than Januvia for Type 2 Diabetes Mellitus
Mary K. Caffrey
Another Distinct Link Between Cancer and Obesity: the AEG-1 Protein
Surabhi Dangi-Garimella, PhD
Survey Finds Young Patients With Diabetes Getting Fewer Eye Exams Than Older Patients
Mary K. Caffrey
Currently Reading
Fingernail Tests May Offer Cheap, Simple Way to Diagnose Diabetes
Mary K. Caffrey
Food Industry Discusses DGAC Call for Sugar Limits, but Many Are Cutting Back Already
Molly Bourg
If Beef Is Not Sustainable, Is Growing It the Answer?
Molly Bourg
Synjardy Joins Ranks of Combo Therapies for T2DM
Mary K. Caffrey
Non-Surgical Balloon Device Approved to Treat Obesity
Mary K. Caffrey
Dexcom G5 Mobile CGM System Approved by FDA
Mary K. Caffrey

Fingernail Tests May Offer Cheap, Simple Way to Diagnose Diabetes

Mary K. Caffrey
Fingernail tests could offer a solution to diabetes testing in the developing world, and a faster test for gestational diabetes could diagnose this condition earlier in pregnancy.
A simple test of fingernail clippings could replace a blood draw as a way to diagnose and monitor type 2 diabetes mellitus (T2DM), with huge implications for tracking the disease in the developing world.

Research on this method by a team of Belgian researchers was reported July 28, 2015, at the 2015 American Association for Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo in Atlanta. The team, led by Joris R. Delanghe, MD, PhD, of the Department of Global Chemistry, Microbiology and Immunology at Ghent University, collected nail clippings from 25 people with T2DM and 25 without the disease. The clippings were ground into a powder and tested with an inexpensive FT-IR photometer to measure how much the protein in the nails had bonded with sugar molecules, a process known as glycation.
 
“We found a striking difference in the measurements between the control group and the patients with diabetes,” Delanghe said. In an interview with Evidence-Based Diabetes Management, he said replacing the standard blood test to measure glycated hemoglobin is a huge advantage. In many cultures, he said, “Taking blood is something that cannot be tolerated.”
 
As a practical matter, blood draws present safety, refrigeration, and storage problems for public health workers. Fingernail clippings, by contrast, are stable and can be stored for weeks at high temperatures. “All the equipment you need to analyze them can be stored in a car,” he said. 
 
The concept of using fingernail clippings instead of the standard blood test grew out of discussions with graduate students, who advised that cultural barriers to drawing blood to diagnose T2DM had to be overcome. “It’s a nice example of how an exchange of ideas with people from various countries can lead to a new approach for diagnosing diabetes,” Delanghe said.
 
He is not seeking a patent on the idea, because he hopes it can be useful to public health officials in places like India and Southeast Asia where T2DM incidence is on the rise. This way, Delanghe said, “It will be available for everyone.”
 
A FASTER TEST FOR GESTATIONAL DIABETES
 
Sridevi Devaraj, PhD, director of clinical chemistry at Texas Children’s Hospital and a professor at Baylor College of Medicine, Houston, presented results at AACC on July 28, 2015, that could become a faster, earlier test for gestational diabetes.
 
The standard biomarker, A1C, has limited usefulness during pregnancy, but the current glucose tolerance test for pregnant women takes 3 hours and requires fasting—a process that Devaraj said is quite time consuming and unpleasant. In addition, it cannot be performed until 3 months into pregnancy.
 
Devaraj and her team collected blood samples from 124 pregnant women and examined 3 different blood proteins. They found that the levels of 1 protein, called 1,5-anhydroglucitol or 1,5-AG, were significantly different from women already diagnosed with gestational diabetes. In addition, researchers were able to establish a cut-off level for 1,5-AG that indicated gestational diabetes.
 
She noted in an interview that her results are retrospective and must now be confirmed in a larger, prospective study. But Devaraj is hopeful that she is in the initial stages of developing an improved test for earlier detection of gestational diabetes, with better outcomes for mother and baby. “The good thing with pregnant women is that they will come in for their checkups,” she said. “If the lab is there, they will do it.”
PDF
 
Copyright AJMC 2006-2020 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up