Monitoring of glucose in people living with diabetes mellitus: A study comparing nano-based acetone/glucose breath analyzer, two commercial glucometers and laboratory-based glucose analysis

Non-invasive glucose testing is one of the novel methods for monitoring glucose in people living with diabetes mellitus. We researched how breathe acetone derived glucose levels compare to serum glucose and capillary glucose measure on two commercial glucose meters in diabetes mellitus patients at Steve Biko Academic Hospital. Breath acetone samples were collected in 127 patients from a diabetes clinic which was compared to lab analysed glucose and other 2 commercial glucose meters in a cross-sectional study. 69% $\boldsymbol{(\mathrm{n}=87)}$ of participants had type 1 diabetes. The majority of the diabetes patients were African 49 (58.34%). The mean acetone derived glucose level was $\boldsymbol{9.3\pm 4.3}$ mm whereas laboratory glucose mean was $\boldsymbol{9.5\pm 5.3}$ mmol/l, Accu-Chek meter mean was $\boldsymbol{10\pm 4.3}$ mmol/L and On Call Plus meter mean was $\boldsymbol{9.8\pm 5}$ mmol/L. After adjusting for body mass index, sex, race, age and other variables, there was no difference between breath acetone and laboratory glucose measurements (coefficient 0.20, confidence interval-0.41 to 0.81 and P-value 0.511). Our study reports that breath acetone glucose is comparable to laboratory glucose measurement and the 2 glucometers used for monitoring in diabetes mellitus. Therefore, the device could be of clinical importance in the monitoring of glucose in diabetics. Further exploration of its use on screening for elevated glucose or criticalcare is suggested.