Transdermal Blood Sampling for C-Peptide Is a Minimally Invasive, Reliable Alternative to Venous Sampling in Children and Adults With Type 1 Diabetes
C-peptide and islet autoantibodies are key type 1 diabetes biomarkers, typically requiring venous sampling, which limits their utility. We assessed transdermal capillary blood (TCB) collection as a practical alternative. Ninety-one individuals (71 with type 1 diabetes, 20 control; individuals with t...
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| Veröffentlicht in: | Diabetes care 2024-02, Vol.47 (2), p.239-245 |
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| creator | Besser, Rachel E J Long, Anna E Owen, Katharine R Law, Rebecca Birks, Jacqueline S Pearce, Olivia Williams, Claire L Scudder, Claire L McDonald, Timothy J Todd, John A |
| description | C-peptide and islet autoantibodies are key type 1 diabetes biomarkers, typically requiring venous sampling, which limits their utility. We assessed transdermal capillary blood (TCB) collection as a practical alternative.
Ninety-one individuals (71 with type 1 diabetes, 20 control; individuals with type 1 diabetes: aged median 14.8 years [interquartile range (IQR) 9.1-17.1], diabetes duration 4.0 years [1.5-7.7]; control individuals: 42.2 years [38.0-52.1]) underwent contemporaneous venous and TCB sampling for measurement of plasma C-peptide. Participants with type 1 diabetes also provided venous serum and plasma, and TCB plasma for measurement of autoantibodies to glutamate decarboxylase, islet antigen-2, and zinc transporter 8. The ability of TCB plasma to detect significant endogenous insulin secretion (venous C-peptide ≥200 pmol/L) was compared along with agreement in levels, using Bland-Altman. Venous serum was compared with venous and TCB plasma for detection of autoantibodies, using established thresholds. Acceptability was assessed by age-appropriate questionnaire.
Transdermal sampling took a mean of 2.35 min (SD 1.49). Median sample volume was 50 µL (IQR 40-50) with 3 of 91 (3.3%) failures, and 13 of 88 (14.7%) |
| doi_str_mv | 10.2337/dc23-1379 |
| format | Article |
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Ninety-one individuals (71 with type 1 diabetes, 20 control; individuals with type 1 diabetes: aged median 14.8 years [interquartile range (IQR) 9.1-17.1], diabetes duration 4.0 years [1.5-7.7]; control individuals: 42.2 years [38.0-52.1]) underwent contemporaneous venous and TCB sampling for measurement of plasma C-peptide. Participants with type 1 diabetes also provided venous serum and plasma, and TCB plasma for measurement of autoantibodies to glutamate decarboxylase, islet antigen-2, and zinc transporter 8. The ability of TCB plasma to detect significant endogenous insulin secretion (venous C-peptide ≥200 pmol/L) was compared along with agreement in levels, using Bland-Altman. Venous serum was compared with venous and TCB plasma for detection of autoantibodies, using established thresholds. Acceptability was assessed by age-appropriate questionnaire.
Transdermal sampling took a mean of 2.35 min (SD 1.49). Median sample volume was 50 µL (IQR 40-50) with 3 of 91 (3.3%) failures, and 13 of 88 (14.7%) <35 µL. TCB C-peptide showed good agreement with venous plasma (mean venous ln[C-peptide] - TCB ln[C-peptide] = 0.008, 95% CI [-0.23, 0.29], with 100% [36 of 36] sensitivity/100% [50 of 50] specificity to detect venous C-peptide ≥200 pmol/L). Where venous serum in multiple autoantibody positive TCB plasma agreed in 22 of 32 (sensitivity 69%), comparative specificity was 35 of 36 (97%). TCB was preferred to venous sampling (type 1 diabetes: 63% vs. 7%; 30% undecided).
Transdermal capillary testing for C-peptide is a sensitive, specific, and acceptable alternative to venous sampling; TCB sampling for islet autoantibodies needs further assessment.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc23-1379</identifier><identifier>PMID: 38087932</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Acceptability ; Autoantibodies ; Biomarkers ; Blood ; Diabetes ; Diabetes mellitus (insulin dependent) ; Glutamate decarboxylase ; Insulin ; Insulin secretion ; Peptides ; Plasma ; Research design ; Sampling ; Sensitivity ; Zinc transporter</subject><ispartof>Diabetes care, 2024-02, Vol.47 (2), p.239-245</ispartof><rights>2024 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Feb 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2239-79bdd80e43904845aee36a38ba12044f532d73ae118dac0ee9fee9743267fd9c3</cites><orcidid>0000-0003-3559-6660 ; 0000-0002-6847-2771 ; 0000-0002-4645-6324</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38087932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Besser, Rachel E J</creatorcontrib><creatorcontrib>Long, Anna E</creatorcontrib><creatorcontrib>Owen, Katharine R</creatorcontrib><creatorcontrib>Law, Rebecca</creatorcontrib><creatorcontrib>Birks, Jacqueline S</creatorcontrib><creatorcontrib>Pearce, Olivia</creatorcontrib><creatorcontrib>Williams, Claire L</creatorcontrib><creatorcontrib>Scudder, Claire L</creatorcontrib><creatorcontrib>McDonald, Timothy J</creatorcontrib><creatorcontrib>Todd, John A</creatorcontrib><title>Transdermal Blood Sampling for C-Peptide Is a Minimally Invasive, Reliable Alternative to Venous Sampling in Children and Adults With Type 1 Diabetes</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>C-peptide and islet autoantibodies are key type 1 diabetes biomarkers, typically requiring venous sampling, which limits their utility. We assessed transdermal capillary blood (TCB) collection as a practical alternative.
Ninety-one individuals (71 with type 1 diabetes, 20 control; individuals with type 1 diabetes: aged median 14.8 years [interquartile range (IQR) 9.1-17.1], diabetes duration 4.0 years [1.5-7.7]; control individuals: 42.2 years [38.0-52.1]) underwent contemporaneous venous and TCB sampling for measurement of plasma C-peptide. Participants with type 1 diabetes also provided venous serum and plasma, and TCB plasma for measurement of autoantibodies to glutamate decarboxylase, islet antigen-2, and zinc transporter 8. The ability of TCB plasma to detect significant endogenous insulin secretion (venous C-peptide ≥200 pmol/L) was compared along with agreement in levels, using Bland-Altman. Venous serum was compared with venous and TCB plasma for detection of autoantibodies, using established thresholds. Acceptability was assessed by age-appropriate questionnaire.
Transdermal sampling took a mean of 2.35 min (SD 1.49). Median sample volume was 50 µL (IQR 40-50) with 3 of 91 (3.3%) failures, and 13 of 88 (14.7%) <35 µL. TCB C-peptide showed good agreement with venous plasma (mean venous ln[C-peptide] - TCB ln[C-peptide] = 0.008, 95% CI [-0.23, 0.29], with 100% [36 of 36] sensitivity/100% [50 of 50] specificity to detect venous C-peptide ≥200 pmol/L). Where venous serum in multiple autoantibody positive TCB plasma agreed in 22 of 32 (sensitivity 69%), comparative specificity was 35 of 36 (97%). TCB was preferred to venous sampling (type 1 diabetes: 63% vs. 7%; 30% undecided).
Transdermal capillary testing for C-peptide is a sensitive, specific, and acceptable alternative to venous sampling; TCB sampling for islet autoantibodies needs further assessment.</description><subject>Acceptability</subject><subject>Autoantibodies</subject><subject>Biomarkers</subject><subject>Blood</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Glutamate decarboxylase</subject><subject>Insulin</subject><subject>Insulin secretion</subject><subject>Peptides</subject><subject>Plasma</subject><subject>Research design</subject><subject>Sampling</subject><subject>Sensitivity</subject><subject>Zinc transporter</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpdkc-KE0EQhxtZMdnVw77AUrAXBUf732S6jzGuGlhRNOpx6EzXmA6dntnumUAexPe1Q6KCh6Kg-PhRVR8h14y-4kJUr23DRcFEpR-RKdOiLMpSqgsypUzqotSaT8hlSltKqZRKPSEToaiqtOBT8msVTUgW4854eOO7zsJXs-u9Cz-h7SIsis_YD84iLBMY-OiCy6Q_wDLsTXJ7fAlf0Duz9ghzP2AMZshTGDr4jqEb0784F2Cxcd5GDGCChbkd_ZDghxs2sDr0CAze5iAcMD0lj1vjEz479yvy7d3davGhuP_0frmY3xcN50IXlV5bqyhKoalUsjSIYmaEWhvG86ltKbithEHGlDUNRdRtrkoKPqtaqxtxRZ6fcvvYPYyYhnrnUoPem4B595pryrXkivKM3v6HbrsxX-uPFKezmSyrMlMvTlQTu5QitnUf88PioWa0Prqqj67qo6vM3pwTx_UO7V_yjxzxG3gdjoI</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Besser, Rachel E J</creator><creator>Long, Anna E</creator><creator>Owen, Katharine R</creator><creator>Law, Rebecca</creator><creator>Birks, Jacqueline S</creator><creator>Pearce, Olivia</creator><creator>Williams, Claire L</creator><creator>Scudder, Claire L</creator><creator>McDonald, Timothy J</creator><creator>Todd, John A</creator><general>American Diabetes Association</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3559-6660</orcidid><orcidid>https://orcid.org/0000-0002-6847-2771</orcidid><orcidid>https://orcid.org/0000-0002-4645-6324</orcidid></search><sort><creationdate>20240201</creationdate><title>Transdermal Blood Sampling for C-Peptide Is a Minimally Invasive, Reliable Alternative to Venous Sampling in Children and Adults With Type 1 Diabetes</title><author>Besser, Rachel E J ; Long, Anna E ; Owen, Katharine R ; Law, Rebecca ; Birks, Jacqueline S ; Pearce, Olivia ; Williams, Claire L ; Scudder, Claire L ; McDonald, Timothy J ; Todd, John A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2239-79bdd80e43904845aee36a38ba12044f532d73ae118dac0ee9fee9743267fd9c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acceptability</topic><topic>Autoantibodies</topic><topic>Biomarkers</topic><topic>Blood</topic><topic>Diabetes</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Glutamate decarboxylase</topic><topic>Insulin</topic><topic>Insulin secretion</topic><topic>Peptides</topic><topic>Plasma</topic><topic>Research design</topic><topic>Sampling</topic><topic>Sensitivity</topic><topic>Zinc transporter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Besser, Rachel E J</creatorcontrib><creatorcontrib>Long, Anna E</creatorcontrib><creatorcontrib>Owen, Katharine R</creatorcontrib><creatorcontrib>Law, Rebecca</creatorcontrib><creatorcontrib>Birks, Jacqueline S</creatorcontrib><creatorcontrib>Pearce, Olivia</creatorcontrib><creatorcontrib>Williams, Claire L</creatorcontrib><creatorcontrib>Scudder, Claire L</creatorcontrib><creatorcontrib>McDonald, Timothy J</creatorcontrib><creatorcontrib>Todd, John A</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Besser, Rachel E J</au><au>Long, Anna E</au><au>Owen, Katharine R</au><au>Law, Rebecca</au><au>Birks, Jacqueline S</au><au>Pearce, Olivia</au><au>Williams, Claire L</au><au>Scudder, Claire L</au><au>McDonald, Timothy J</au><au>Todd, John A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transdermal Blood Sampling for C-Peptide Is a Minimally Invasive, Reliable Alternative to Venous Sampling in Children and Adults With Type 1 Diabetes</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>47</volume><issue>2</issue><spage>239</spage><epage>245</epage><pages>239-245</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>C-peptide and islet autoantibodies are key type 1 diabetes biomarkers, typically requiring venous sampling, which limits their utility. We assessed transdermal capillary blood (TCB) collection as a practical alternative.
Ninety-one individuals (71 with type 1 diabetes, 20 control; individuals with type 1 diabetes: aged median 14.8 years [interquartile range (IQR) 9.1-17.1], diabetes duration 4.0 years [1.5-7.7]; control individuals: 42.2 years [38.0-52.1]) underwent contemporaneous venous and TCB sampling for measurement of plasma C-peptide. Participants with type 1 diabetes also provided venous serum and plasma, and TCB plasma for measurement of autoantibodies to glutamate decarboxylase, islet antigen-2, and zinc transporter 8. The ability of TCB plasma to detect significant endogenous insulin secretion (venous C-peptide ≥200 pmol/L) was compared along with agreement in levels, using Bland-Altman. Venous serum was compared with venous and TCB plasma for detection of autoantibodies, using established thresholds. Acceptability was assessed by age-appropriate questionnaire.
Transdermal sampling took a mean of 2.35 min (SD 1.49). Median sample volume was 50 µL (IQR 40-50) with 3 of 91 (3.3%) failures, and 13 of 88 (14.7%) <35 µL. TCB C-peptide showed good agreement with venous plasma (mean venous ln[C-peptide] - TCB ln[C-peptide] = 0.008, 95% CI [-0.23, 0.29], with 100% [36 of 36] sensitivity/100% [50 of 50] specificity to detect venous C-peptide ≥200 pmol/L). Where venous serum in multiple autoantibody positive TCB plasma agreed in 22 of 32 (sensitivity 69%), comparative specificity was 35 of 36 (97%). TCB was preferred to venous sampling (type 1 diabetes: 63% vs. 7%; 30% undecided).
Transdermal capillary testing for C-peptide is a sensitive, specific, and acceptable alternative to venous sampling; TCB sampling for islet autoantibodies needs further assessment.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>38087932</pmid><doi>10.2337/dc23-1379</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3559-6660</orcidid><orcidid>https://orcid.org/0000-0002-6847-2771</orcidid><orcidid>https://orcid.org/0000-0002-4645-6324</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2024-02, Vol.47 (2), p.239-245 |
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| subjects | Acceptability Autoantibodies Biomarkers Blood Diabetes Diabetes mellitus (insulin dependent) Glutamate decarboxylase Insulin Insulin secretion Peptides Plasma Research design Sampling Sensitivity Zinc transporter |
| title | Transdermal Blood Sampling for C-Peptide Is a Minimally Invasive, Reliable Alternative to Venous Sampling in Children and Adults With Type 1 Diabetes |
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