Simple and non-invasive screening method for diabetes based on myoinositol levels in urine samples collected at home

• Main Authors: Misaki Takakado, Yasunori Takata, Fumio Yamagata, Michiko Yaguchi, Go Hiasa, Sumiko Sato, Jun-ichi Funada, Shoji Kawazu, Haruhiko Osawa
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2020-04-01
• Series: BMJ Open Diabetes Research & Care
• Online Access: https://drc.bmj.com/content/8/1/e000984.full

ObjectiveTo establish a simple screening method for diabetes based on myoinositol (MI) in urine samples collected at home.Research design and methodsInitially, we evaluated the stability of urinary MI (UMI) at room temperature (RT; 25°C) and 37°C in 10 outpatients with type 2 diabetes. We then enrolled 115 volunteers without a current or history of diabetes. In all subjects, glucose intolerance was diagnosed by 75 g oral glucose tolerance test (75gOGTT). To assess the association between UMI or urine glucose (UG) and plasma glucose (PG), urine samples were also collected at 0 and 2 hours during 75gOGTT. All the subjects collected urine samples at home before and 2 hours after consuming the commercially available test meal. UMI levels at wake-up time (UMIwake-up), before (UMIpremeal) and 2 hours after the test meal (UMI2h-postprandial) were measured using an enzymatic method. ΔUMI was defined as UMI2h-postprandial minus UMIpremeal.ResultsDiffering from UG, UMI was stable at RT and 37°C. UMI was increased linearly along with an increase in PG, and no threshold for UMI was observed. UMI was closely associated with blood glucose parameters obtained from a 75gOGTT and hemoglobin A1c (HbA1c) at hospital after adjustment for age, sex, body mass index and serum creatinine. UMIwake-up, UMIpremeal, UMI2h-postprandial and ΔUMI at home were higher in diabetic subjects than non-diabetic subjects even after the above adjustment. Receiver operating characteristics curve (ROC) analyses revealed that for the screening of diabetes, the area under the curve for ROC for UMI2h-postprandial and ΔUMI (0.83 and 0.82, respectively) were not inferior to that for HbA1c ≥48 mmol/mol, which is the American Diabetes Association (ADA) criteria for diabetes.ConclusionsMI measurement in urine samples collected at home before and after the meal would be a simple, non-invasive and valuable screening method for diabetes.