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Association between tear and blood glucose concentrations: Random intercept model adjusted with confounders in tear samples negative for occult blood
Authors:Masakazu Aihara  Naoto Kubota  Takahiro Minami  Rika Shirakawa  Yoshitaka Sakurai  Takanori Hayashi  Masahiko Iwamoto  Iseki Takamoto  Tetsuya Kubota  Ryo Suzuki  Satoshi Usami  Hideaki Jinnouchi  Makoto Aihara  Toshimasa Yamauchi  Toshiya Sakata  Takashi Kadowaki
Institution:1. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Clinical Nutrition Program, National Institute of Health and Nutrition, Tokyo, Japan;4. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Department of Diabetes and Endocrinology, Nerima Hikarigaoka Hospital, Tokyo, Japan;5. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Clinical Nutrition Program, National Institute of Health and Nutrition, Tokyo, Japan

Laboratory for Metabolic Homeostasis, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan

Analysis Tool Development Group, Intestinal Microbiota Project, Kanagawa Institute of Industrial Science and Technology, Kanagawa, Japan

Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan;6. Graduate School of Education, The University of Tokyo, Tokyo, Japan;7. Jinnouchi Hospital, Kumamoto, Japan;8. Department of Materials Science and Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan

Abstract:Aims/IntroductionTo prevent diabetic complications, strict glucose control and frequent monitoring of blood glucose levels with invasive methods are necessary. We considered the monitoring of tear glucose levels might be a possible method for non‐invasive glucose monitoring. To develop tear glucose monitoring for clinical application, we investigated the precise correlation between the blood and tear glucose concentrations.Materials and MethodsA total of 10 participants and 20 participants with diabetes were admitted, and blood and tear samples were collected. Before statistical analysis, we eliminated tear samples contaminated with blood. We observed the daily blood and tear glucose dynamics, and carried out a random intercept model analysis to examine the association between the blood and tear glucose concentrations.ResultsTear occult blood tests showed that the tear glucose concentrations and their variation increased in both participants with and without diabetes as contamination of blood increased. In both participants with and without diabetes, fluctuations of the plasma glucose concentrations were observed depending on the timing of collection of the samples, and the dynamics of the tear glucose concentrations paralleled those of the plasma glucose concentrations. The random intercept model analysis showed a significant association between the plasma and tear glucose concentrations in participants with diabetes (P < 0.001). This association still existed even after adjusting for the glycated hemoglobin levels and the prandial state (P < 0.001).ConclusionsIt is important to eliminate the tear samples contaminated with blood. Tear glucose monitoring might be a reliable and non‐invasive substitute method for monitoring the blood glucose concentrations for diabetes patients, irrespective of glycated hemoglobin levels and timing of sample collection.
Keywords:Glucose monitoring  Non-invasive  Tear
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