Frontiers in Endocrinology (May 2024)

Metabolic trajectories of diabetic ketoacidosis onset described by breath analysis

  • Mo Awchi,
  • Mo Awchi,
  • Kapil Dev Singh,
  • Kapil Dev Singh,
  • Sara Bachmann Brenner,
  • Sara Bachmann Brenner,
  • Marie-Anne Burckhardt,
  • Marie-Anne Burckhardt,
  • Melanie Hess,
  • Melanie Hess,
  • Jiafa Zeng,
  • Jiafa Zeng,
  • Alexandre N. Datta,
  • Alexandre N. Datta,
  • Urs Frey,
  • Urs Frey,
  • Urs Zumsteg,
  • Gabor Szinnai,
  • Gabor Szinnai,
  • Pablo Sinues,
  • Pablo Sinues

DOI
https://doi.org/10.3389/fendo.2024.1360989
Journal volume & issue
Vol. 15

Abstract

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PurposeThis feasibility study aimed to investigate the use of exhaled breath analysis to capture and quantify relative changes of metabolites during resolution of acute diabetic ketoacidosis under insulin and rehydration therapy.MethodsBreath analysis was conducted on 30 patients of which 5 with DKA. They inflated Nalophan bags, and their metabolic content was subsequently interrogated by secondary electrospray ionization high-resolution mass spectrometry (SESI-HRMS).ResultsSESI-HRMS analysis showed that acetone, pyruvate, and acetoacetate, which are well known to be altered in DKA, were readily detectable in breath of participants with DKA. In addition, a total of 665 mass spectral features were found to significantly correlate with base excess and prompt metabolic trajectories toward an in-control state as they progress toward homeostasis.ConclusionThis study provides proof-of-principle for using exhaled breath analysis in a real ICU setting for DKA monitoring. This non-invasive new technology provides new insights and a more comprehensive overview of the effect of insulin and rehydration during DKA treatment.

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