23 November 2011

(Reuters Health) – Giving a “muffin test” to people at risk for diabetes might help doctors diagnose the disease and its warning signs, according to a new study.

Tests for diabetes and its precursor, impaired glucose tolerance, check how well the body uses glucose, a type of sugar.

In one common test, called an oral glucose tolerance test, a person fasts overnight and then drinks a sugary solution while doctors monitor how the body reacts and how much sugar sticks around in the blood.

Researchers behind the new report wondered if people might prefer munching on a muffin to downing the glucose drink — and if a muffin test would give doctors a better idea of how the body deals with real food.

“Women really hate to get tested” with the oral glucose tolerance test, said Dr. Michael Traub of the Albert Einstein College of Medicine in Bronx, New York, who worked on the study.

“It’s really not such a pleasant test,” he told Reuters Health, adding that many people often feel ill from the drink.

“A muffin more closely resembles what someone really eats — it may just provide a more adequate test.”

The findings suggest the muffin test was able to diagnose women with impaired glucose tolerance, and 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 doctors know exactly what’s in the glucose drink and can judge how each person responds equally.

“Getting a standardized muffin across the United States and across the world I think would be challenging,” Herman told Reuters Health.

Using a glucose drink, he said, is “probably more convenient. Glucose solutions have a longer shelf-life. We know exactly what’s in them.”

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 flavors, including chocolate chip, corn and blueberry. Two hours later, Traub and his colleagues measured the amount of glucose in their blood to determine how well the body had used sugar in the baked goods.

A smaller group of 12 women also had a standard oral glucose tolerance test involving the sugary solution.

According to the muffin test, eight of the 73 women had impaired glucose tolerance — and more than half of those would have been missed by a regular blood test done after fasting, researchers reported in Menopause.

The muffin test diagnosed two women in the 12-person group with the early signs of diabetes. One of those was also spotted by the oral glucose tolerance test.

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 give any women stomach problems, like the solution sometimes does.

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 show that’s the case.

Still, Herman had his doubts as to the usefulness of a muffin test.

“I just think that we have more standardized 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.

“There still is a lot of undiagnosed diabetes and glucose intolerance out there. It is important to identify people with glucose intolerance.”

Treating people with early blood sugar problems with drugs or advising weight loss and physical activity can help delay or prevent full-on diabetes, he added.

This article was published in www.reuters.com on 26 October 2011