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Monitoring states of altered carbohydrate metabolism via breath analysis: are times ripe for transition from potential to reality?

Dowlaty, Newsha*; Yoon, Amanda*; Galassetti, Pietro

Current Opinion in Clinical Nutrition & Metabolic Care:
doi: 10.1097/MCO.0b013e328361f91f
CARBOHYDRATES: Edited by Luc Tappy and Bettina Mittendorfer

Purpose of review: To introduce the potential of breath analysis as a diagnostic or monitoring tool in diabetes.

Recent findings: Blood testing for plasma glucose and other metabolic variables is the base for the diagnosis and management of diabetes, whose two main types (type 1 and type 2, T1DM, T2DM) are projected to affect 450 million by 2030. As blood testing is often uncomfortable, painful, costly, and in some situations unreliable, the quest for alternative, noninvasive methods has been ongoing for decades. Breath analysis has emerged as an ideal alternative as sample collection is easy, painless, flexible, noninvasive, practical, and inexpensive. No single exhaled gas can reflect systemic glucose concentrations. Multiple gases, however, have been linked to various aspects of glucose metabolism, and integrated analysis of their simultaneous profiles during prolonged glycemic fluctuations has yielded accurate predictions of plasma values, building expectation that a clinically usable breath-based glucometer may be developed within a few years.

Summary: While prototypes of hand-held breath testing glucometers may still be several years away, current research shows the imminent promise of this methodology and the widening support for its development.

Author Information

Institute for Clinical and Translational Science, University of California, Irvine, California, USA

*Both the authors contributed equally to the manuscript.

Correspondence to Pietro Galassetti, MD, PhD, Associate Professor of Pediatrics and Pharmacology, Director, Metabolism/Bionutrition Core – ICTS, University of California, Irvine, 843 Health Sciences Rd. – Room 1111, Irvine, CA 92697 – 1385, USA. Tel: +1 949 824 3353; fax: +1 949 824 3360; e-mail:

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