A New Tool for Detecting Undiagnosed Diabetes and Prediabetes
FDA clears device that detects long-term glucose trends
By A. Paul Chous, MA, OD, FAAO
Recently, a new device designed to measure long-term, high blood glucose levels received FDA clearance. The device, the Freedom-Meditech DS-120, is made by a company in San Diego, CA and is based on several decades worth of research showing that elevated blood glucose leads to the formation of irreversible chemical bonds that form between sugar and protein, what are called advanced glycation endproducts, or AGEs. This same chemical reaction is what causes the browning of a holiday turkey – at elevated temperature, glucose (sugar) in the skin of the turkey becomes permanently ‘stuck' to the proteins (amino acids) in the meat of the turkey, resulting in the golden-brown skin so many of us have come to associate with Thanksgiving.
This process occurs in our bodies all the time, whether we have diabetes or not, when glucose inside and outside of our cells becomes chemically bound to proteins throughout the body in our muscles, skin, and internal organs. AGEs emit light of a different wavelength (color) when they are exposed to light of another wavelength, a property known as bio-fluorescence. Glucose is particularly attracted to collagen, and the internal lens of the eye contains lots of collagen that allows formation of AGEs over time, which can then be measured by shining light through the lens and measuring bio-fluorescence with sophisticated optical sensors. When blood glucose levels are elevated for a long period of time - as happens gradually years before people start to develop diabetes and more rapidly as overt diabetes and associated hyperglycemia is detected by conventional blood testing - AGEs form at a much higher rate within the eye's lens and give us a unique chance to detect blood glucose abnormalities possibly years before diabetes is diagnosed by conventional methods.
How The Freedom-Meditech DS-120 Works
By comparing an individual's levels of lens AGEs to levels found in people of various ages both with and without diabetes, we now have a commercially available device to identify people whose blood glucose levels are higher than normal over decades and who are at greater risk for ultimately developing diabetes – this is analogous to an A1c (hemoglobin A-1-c) that tells you and your doctor your average blood sugar level not over a 2-3 month period of time, but over your entire lifespan. In fact, early data shows that measuring lens AGEs with this non-invasive, six-second test may not only detect undiagnosed diabetes more accurately than standard blood analysis like fasting blood glucose testing, glucose tolerance testing, or A1c, but also identify people who are at high risk for ultimately developing diabetes up to seven years before standard blood tests reveal the disease. This kind of early detection of elevated risk may be critically important, as research clearly shows the onset of type 2 diabetes and diabetes complications may be largely delayed or prevented with lifestyle modification (as revealed by the randomized, multi-center clinical trial, the Diabetes Prevention Program).
The Freedom-Meditech DS-120
Because elevated AGEs are known to contribute to virtually all diabetes complications, including eye, kidney, and nerve damage, periodic measurement of lens AGEs may also give us a better tool for not only evaluating long-term diabetes control, but also the risk of developing these notorious complications after a patient is diagnosed with diabetes. This technology is just becoming available to eye doctors around the US, so if you are interested, tell your eye doctor about this article and the technology. Medical insurance does not cover this test at the moment, but it may be well worth paying a relatively low out-of-pocket fee for this valuable information.
Disclosure: Dr. Chous wants dLife readers to know that he is on an advisory board to the company making this device.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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