Diabetic? Look Into Your Mouth

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A painless route to early diabetes detection: —

Bye bye, painful finger pricks. Now a spit is more than enough to know whether you suffer from diabetes. The news is particularly sweet for the millions who are feared to be on the verge of joining the growing global epidemic called diabetes.

The alarm for the disease may now be rung really early. A saliva test, developed by a team of researchers from the Hyderabad-based Nizam’s Institute of Medical Sciences (Nims) and their counterparts in a private US firm, may help to spot the metabolic changes associated with diabetes much before the clinical symptoms set in. An early diagnosis can help patients keep the blood sugar levels in check, thus avoiding diabetes-linked complications that afflict many organs including the kidney and eyes.

The study, which appeared online recently in the Journal of Proteome Research, reports that even in a country like the US (boasting of an efficient healthcare system) nearly seven per cent of the newly diagnosed type-2 diabetes patients had actually been diabetic for approximately 4-7 years before the diagnosis. “The ability to ascertain those individuals at risk for the development for clinically apparent diabetes is critical to effectively focus potentially limited clinical resources,” the researchers say in the paper.

The scientists have found that out of a total of 487 proteins in human saliva, in diabetics 65 are more than twice as high as compared to normal people. More significantly, such raised protein levels are found in those who are years away from being full-fledged diabetics. The scientists claim that the level of these biomarkers — which are associated with metabolism and immune response — are noticeably high even in those suffering from impaired glucose tolerance and impaired fasting glucose, which manifest much before clinical symptoms of diabetes set in.

“Our primary objective is to find an alternative to the conventional blood sugar test for diagnosis and monitoring, the latter being important to adjust drug doses,” says Paturi V. Rao, a researcher at Nims and first author of the study. “It is possible to replace blood glucose tests with urine and saliva tests,” says Rao whose team reported a similar work with urine proteins last year.

According to Dr Anoop Misra, head of internal medicine at the Fortis Group of Hospitals, New Delhi, the work is exciting as it opens a new avenue of research into early diagnosis of diabetes (which currently afflicts more than 30 million Indians). The more worrying concern for medical experts is that the number is still climbing and the curve is nowhere near taking a downward plunge.

Misra, however, doesn’t expect it to come to the realm of practical application too soon. “Blood test remains the gold standard for diabetes diagnosis. I don’t think anything can replace it soon,” he says.

If the saliva test can pick up early signals of diabetes, as the scientists claim, it can prove to be a boon — families, in which members are diabetic, can ascertain whether the disease has been handed down to the offspring. For instance, a 13-year-old in a diabetic family can be checked to see whether he or she will become diabetic, say, 10 years later, Misra hopes.

Rao, who collaborates with the Oregon-based US firm DiabetOmics in this new research, says the team has found enough urine and saliva markers in diabetes. “Our urine test device should be ready by this year end and the saliva device next year,” Rao told KnowHow from Berlin.

An additional advantage of having such a non-invasive diagnosis, according to the authors, is that it can make more diabetics comply with regular monitoring. “Compliance with glucose monitoring is poor because of the pain and inconvenience of the conventional blood collection using lancets,” the researchers say.

The saliva test is the latest among several non-invasive diagnostic methods being attempted by medical scientists. Nearly two years ago, GlucoLight, a Pennsylvania-based company, announced the availability of a painless way of measuring blood sugar levels using light beams. The technique is said to be particularly useful for those who need to check sugar levels several times a day for taking insulin jabs.

Sources: The Telegraph (Kolkata, India)

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