27 October 2011

Can a muffin help diagnose diabetes?

A "muffin test" might help diagnose impaired glucose tolerance and diabetes, according to a new study.


A "muffin test" might help diagnose impaired glucose tolerance and diabetes, according to a new study.

Researchers behind the new report wondered if people might prefer munching on a muffin to taking an oral glucose tolerance test – and whether a muffin test would give a better idea of how the body deals with real food.

Dr Michael Traub of the Albert Einstein College of Medicine in Bronx, New York, who worked on the study, noted that drinking the solution in the oral glucose tolerance test (OGTT) makes many people feel ill. "A muffin more closely resembles what someone really eats – it may just provide a more adequate test," he said.

The findings suggest the muffin test was able to diagnose women with impaired glucose tolerance, and it was cheaper than the standard sugar drink. But a diabetes researcher not involved in the study wondered if doctors really need a baked-good test – and how convenient it would be in the first place.

Muffins are different everywhere, said Dr William Herman, director of the Michigan Diabetes Research and Training Center in Ann Arbor – whereas the solution patients drink in the glucose tolerance test is standardised.

"Getting a standardised muffin across the United States and across the world I think would be challenging," Dr Herman said. The OGTT, he said, is "probably more convenient. Glucose solutions have a longer shelf-life. We know exactly what's in them."

Exaggerated association

The current study involved 73 women in their 40s and 50s. After an overnight fast, the women were given a muffin from a local bakery – one of a variety of flavours, including chocolate chip, corn and blueberry.

Twelve women also had an OGTT, and 10 had a mixed-meal tolerance test. The main outcome measures were the prevalence of impaired glucose tolerance and glucose levels two hours after each type of test.

On multivariable linear regression, two-hour glucose levels were linearly related to fasting values, with an exaggerated association in overweight women.

The authors said glucose levels with the various tests were comparable after OGTT and after mixed meal tolerance tests, although the two-hour glucose levels were slightly lower after OGTT than after the mixed-meal tolerance test.

The muffin test diagnosed impaired glucose tolerance in eight of the 73 women – and more than half of those would have been missed by a regular blood test done after fasting, the researchers reported September 19 in Menopause.

Muffins cheaper

Dr Traub and his colleagues said a muffin, which costs about one dollar, is cheaper than a five-dollar bottle of glucose solution, and it also didn't seem to make any women feel ill.

And he said that even with reasonable variations in muffin type from place to place, the test would likely give consistent results – but that larger studies are needed to confirm that theory.

But Dr Herman remains doubtful. "I just think that we have more standardised testing techniques now, and I think debating how to test and whether we should use muffins or cookies or jelly beans is sort of diverting attention from the fact that people should be tested and treated if they have this," he said.

(Reuters Health, Genevra Pittman, October 2011)


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