Detecting diabetes’ deadly ketones

A simple, hand-held breath testing device that detects deadly ketones has been developed by University of Sydney researchers. The device could mean an end to finger-prick blood tests for diabetes patients.

Electrical and information engineers created the device that measures ketones – chemicals produced in our liver when other forms of energy called energy substrates are not available, such as glucose.  For type 1 diabetes patients, elevated ketone levels can be life-threatening.

Associate Professor Xiaoke Yi, a nanophotonics expert whose specialist research involves photonic signal processing and sensing, led the development team that included University of Sydney postgraduate student Adrian Wu.

The Professor said the research was in part motivated by a colleague’s diabetes condition.

“Monitoring and controlling blood sugar levels are a crucial daily mission for every person managing diabetes.  It is a painful and costly experience for my colleague,” said Professor Yi.

“Unfortunately, current monitoring methods are invasive and need to be done many times daily. Sometimes these tests can be low in efficiency, and inconvenient to do.

“Our current prototype has three parts – an air sampling bag, a sensor head, and a signal processing unit. We are working on putting these three components together in a compact form to make a device similar to an alcohol breath testing device.

“Key features of our technology are that it is needle-free, risk-free and pain-free. It is also fast and has high accuracy in detection,” Associate Professor Yi said.

The 2015 International Diabetes Federation’s Diabetes Atlas reported one in 11 adults have diabetes, or the equivalent of 415 million worldwide. The Federation has also estimated that this number will keep growing, reaching as many as 642 million by 2040.

Two-thirds of these diabetic patients will live in low to middle-income countries the report said.

“It is critical that we continue to develop this low cost monitoring unit,” Associate Professor Yi said.

Diabetic specialist Professor Stephen Twigg, Medical Head of Endocrinology Research Laboratories, Royal Prince Alfred Hospital, supported the engineers in conducting a small-scale study at the University’s Charles Perkins Centre. Results showed the sensing technique was two times more sensitive than the existing finger prick approach.

Professor Twigg said: “As a clinician and a scientist I was excited by the prototype. I am always looking for improved methods of healthcare management for my patients.

“We need cross-disciplines collaborations – in this case, engineering, science and medicine – to create technologies that help keep people healthy and prevent hospital admissions.

“We do know if we can help people to monitor their ketone levels we can prevent hospital admissions.

“When ketones rise to unsafe levels, a person with type 1 or juvenile diabetes is at risk of a dangerous condition called diabetic ketoacidosis.

“Then the body will start to produce ketones as an alternative energy force and the brain and other tissues start to use the ketones. The problem is, in some case, the levels can be life-threatening.

“The engineers have been able to overcome a fundamental problem and present a unique cost-effective and sensitive technology to detect breath ketone without any interference from drinking wine.”

An additional clinical study trialling the device on diabetes patients is planned for the coming months.

The team aims to reduce the size of their prototype to fit comfortably into a handbag or pocket, meaning diabetes patients will be able to test the state of their health anytime and anywhere.