Type II Diabetes Prediction by Skin Autofluorescence

Despite amazing improvements in understanding of diabetes, something like one in ten humans is Type II diabetic.  Take a minute to absorb that; about half a billion people. Very, very obviously better medical tools and interventions are needed, since we as a species seem incapable of eating right (there are other factors, too; I don’t blame anyone for enjoying food). Researchers in the Netherlands and Canada have published a study using skin autofluorescence to detect some markers which accurately predict onset of Type II diabetes in the short term of about four years…unless they die first.

It’s a good study; 72,000 patients. “After a median follow-up of 4 years (range 0.5–10 years), 1056 participants (1.4%) had developed type 2 diabetes, 1258 individuals (1.7%) were diagnosed with CVD, while 928 (1.3%) had died. Baseline skin autofluorescence was elevated in participants with incident type 2 diabetes and/or CVD [(myocardial infarction, coronary interventions, cerebrovascular accident, transient ischemic attack, intermittent claudication or vascular surgery)-ed.] and in those who had died (all p < 0.001), compared with individuals who survived and remained free of the two diseases. Skin autofluorescence predicted the development of type 2 diabetes, CVD and mortality, independent of several traditional risk factors, such as the metabolic syndrome, glucose and HbA_1c.”.

In high-tech terms this isn’t tough; a one-inch square is illuminated with 300-420nm UV and the fluorescence at 420-600nm.  They took the ratio of the two.  They did chemical workups on fasting blood samples as well: “On the same day, HbA_1c (EDTA-anticoagulated) was analyzed using an NGSP-certified turbidimetric inhibition immunoassay on a Cobas Integra 800 CTS analzser (Roche Diagnostics Nederland, Almere, the Netherlands). Serum creatinine was measured on a Roche Modular P chemistry analyzer (Roche, Basel, Switzerland) and renal function was calculated as estimated (e)GFR with the formula developed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) [31]. Total cholesterol and HDL-cholesterol were measured using an enzymatic colorimetric method, triacylglycerol using a colorimetric UV method, and LDL-cholesterol using an enzymatic method, on a Roche Modular P chemistry analyzer (Roche). Fasting blood glucose was measured using a hexokinase method.”

Without doing the rather more expensive bloodwork, a skin fluorescence gizmo could be made cheaply available.  It’s an excellent first step.

Homework:

Skin autofluorescence predicts incident type 2 diabetes, cardiovascular disease and mortality in the general population;
Robert P. van Waateringe, Bernardina T. Fokkens, Sandra N. Slagter,
Melanie M. van der Klauw, Jana V. van Vliet-Ostaptchouk,
Reindert Graaff, Andrew D. Paterson, Andries J. Smit, Helen L. Lutgers,
Bruce H. R. Wolffenbuttel –Published in Open Access