New Method for Assessing Type 2 Diabetes Mellitus From MN: EZSCAN Diabetes Risk Assessment System

With the change of lifestyle and the acceleration of the aging process, the prevalence of type 2 diabetes has rapidly increased. Type 2 diabetes is of great harm, difficult to cure, and costly. It has become a social problem that seriously threatens human survival and health. However, the current detection rate, awareness rate, and control rate of type 2 diabetes are low, which is related to the lack of early risk assessment and prediction techniques. If we can assess the risk of type 2 diabetes early, achieve early diagnosis, and then intervene with relevant risk factors, the complications of diabetes and medical costs will undoubtedly decrease, and the quality of life of patients will also increase.

The EZSCAN Diabetes Risk Assessment System is a new method for assessing type 2 diabetes autonomic neuropathy. The risk of type 2 diabetes and the severity of its complications can be assessed in a simple, noninvasive way.

Methods and principles In the early stage of type 2 diabetes, hyperglycemia can induce microvascular disease, cause neurotrophy and degeneration, involving the sympathetic postganglionic fibers, can make sweat glands secrete function, resulting in reduced sweat ion concentration, decreased electrical conductivity. The EZSCAN Diabetes Risk Assessment System detects sweat gland function by reverse ion method to assess the risk of type 2 diabetes. It uses chronoamperometry to assess sweat gland function in specific parts of the body using low-voltage direct currents that cause reverse ion penetration. The whole set consists of six electrodes, a hand electrode plate, a foot electrode plate, and a forehead electrode band attached to the computer. The electrodes are placed in areas rich in sweat glands such as the forehead, palms, and soles, and a continuous induced current of less than 4 volts is generated between the electrodes. Each electrode is alternately used as an anode and a cathode, and a chronograph direct current method is used to measure the forehead, palm and sole. The partial conductance and whole body conductance and calculate the conductance of the face, hands, and feet. The entire testing process took only 3 minutes and the subjects did not feel any discomfort. The results are graphically shown as a percentage of the risk (ie, risk score). The higher the risk score, the greater the risk of abnormal glucose metabolism. An EZSCAN risk score of 0% to 25% is normal, 25% to 50% is a low risk of abnormal glucose metabolism, and 50% to 100% is a high risk of abnormal glucose metabolism.

Screening for the Value of Type 2 Diabetes Our research team conducted surveys of community residents over the age of 40 in Shanghai to investigate the relevance of the EZSCAN Diabetes Risk Assessment System in Chinese middle-aged and elderly populations and Type 2 Diabetes Mellitus and Type 2 Diabetes Mellitus Screening value. Investigators who have received unified training collect face-to-face interviews to collect information about the subjects’ past history, medication history, family history, smoking and drinking, physical activity, and education level, and perform regular physical examinations (including Height, weight, waist circumference, and blood pressure at rest, etc.) After 10 hours of fasting, the venous blood samples of the subjects were taken and the fasting blood glucose, fasting insulin, HbA1c, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipids were measured. Protein cholesterol (LDL-C) and other indicators. In addition, a 75g glucose tolerance test (OGTT) was performed on all subjects, and the EZSCAN Diabetes Risk Assessment System was used to measure sweat gland function, followed by evaluation of the risk of type 2 diabetes.

The results showed that compared with the normal group, the lower risk of abnormal glucose metabolism and high risk of abnormal glucose metabolism were older, BMI, waist circumference, blood pressure, TG, TC, LDL-C, fasting blood glucose, postprandial 2 hours blood glucose, Fasting insulin, HbA1c levels were higher, and HDL-C levels were lower (P < 0.05). The prevalence rates of diabetes in the normal EZSCAN score group, low glucose risk group, and high risk group of glucose metabolism were 3.41%, 13.14%, and 28.09%, respectively. Trend test results showed that the prevalence of type 2 diabetes showed a significant increase with the increase in EZSCAN risk score (P<0.0001). Correlation analysis showed that after adjusting for various confounding factors, compared with the normal group, the risk of diabetes in the low-risk glycometabolism risk group and the high-risk group was significantly increased, and the relative risk was 3.26 (95% CI: 2.13 ～ 4.98, P<0.0001) and 7.06 (95% CI: 4.57 to 10.90, P<0.0001).

The study shows that the EZSCAN risk score is significantly and independently associated with the prevalence and risk of type 2 diabetes, and can be used to screen for type 2 diabetes with high sensitivity and specificity. Because its operation is simple, non-invasive and painless, it can be used in large-scale population for the risk assessment of abnormal glucose metabolism, but its long-term predictive value remains to be further verified by large-scale prospective studies.