FARGO - Dr. Danling Wang is determined to make keeping track of diabetes as easy as breathing.

The North Dakota State University researcher and her team have created an ultra-sensitive device that measures the amount of acetone a person exhales to help detect if someone is diabetic and to monitor the condition.

They’re now working in a Research and Technology Park lab to micro-miniaturize the device so it can be integrated into a smartphone, which can then relay the data the sensor collects to a patient’s physician as a painless, inexpensive way to monitor blood sugar.

“This can be a tool for screening for pre-diabetes,” Wang said Monday, Jan. 29, adding that the goal is to have the final device be “1 micrometer or less, very small,” in the next two years.

Wang holds two doctoral degrees, one in electrical engineering and the other in optical physics.

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She started working on the device while seeking her electrical engineering doctorate at the University of Washington. At UW, she had been researching sensors for pollution monitoring.

But while pregnant, Wang developed gestational diabetes. She hated the needle pokes needed to test her blood sugar levels.

“It was not very comfortable. Even painful,” Wang said. “I was scared to do that.”

Dr. Danling Wang talks about how tracking glucose levels would be made easier for patients with diabetes with the use of a non-invasive sensor now in the prototype stages at the NDSU Research and Technology Park in north Fargo.
David Samson / The Forum
Dr. Danling Wang talks about how tracking glucose levels would be made easier for patients with diabetes with the use of a non-invasive sensor now in the prototype stages at the NDSU Research and Technology Park in north Fargo. David Samson / The ForumDavid Samson / The Forum

She turned her focus to making diabetes monitoring easy and less invasive, and decided in her research that acetone was a good biomarker to detect diabetes. She then started working on her monitoring device.

She brought the project to NDSU two years ago when she joined the electrical and computer engineering department as an assistant professor. She then launched a nanoelectonic sensor and device lab and formed a team to help turn the research into a marketable device.

Mike Johnson, from Savage, Minn., is a chemist and doctoral student making the nanotechnology materials used to detect acetone. Meanwhile, Razuan Hossain, from Bangladesh, is a doctoral student in electrical and computer engineering, who is using his circuit design experience to make the device more compact.

The current device is very sensitive, able to detect 0.1 parts per million of acetone in an air sample.

A normal amount of acetone in a person’s exhalation is 0.7 ppm, while a higher level, such 1.7 ppm, is in the danger zone for diabetes, Johnson and Wang said.

The device, which is already patented, doesn’t replace blood testing to diagnose diabetes, but it is a less invasive way to determine if further testing or preventative measures are needed, she said.

Diabetes complications can affect major organs and be disabling or even life-threatening. Diabetes can lead to heart and blood vessel disease, including heart attack and stroke; nerve damage (neuropathy); kidney damage or failure; eye damage, including blindness; foot damage; skin and mouth conditions and infections; and pregnancy complications.

Diabetes was the seventh leading cause of death in the United States in 2015 based on the 79,535 death certificates in which diabetes was listed as the underlying cause of death, the American Diabetes Association reports. The ADA reports that $327 billion in costs were tied to diagnosed diabetes in the U.S. in 2017. About $237 billion was spent on direct medical costs, with $90 billion in reduced productivity.

Where Ant-Man looks big

The nanorods that make up the current version of the sensor (which is mounted on a small piece of film) are about 10 nanometers in width and a couple microns long, Johnson said.

A micron is .000039 inch, or 39 millionths of an inch. The average human red blood cell is about 5 microns in diameter, while an average human hair is about 50 to 75 microns in diameter.

A nanometer is even smaller, one billionth of a meter. According to nano.gov, a human hair is 80,000 to 100,000 nanometers in diameter. A single gold atom is about one-third of a nanometer in diameter.

Convenience counts

An easy, pain-free way of testing for diabetes would be welcome, Dr. David Newman, an endocrinologist with Sanford Health in Fargo, said Thursday, Jan. 31.

Dr. David Newman
Dr. David NewmanSanford Health / Special to The Forum

The finger prick blood tests diabetics do to monitor their condition are inconvenient and some patients say they hurt. They may also be done up to 10 times a day, Newman said.

Given that the testing sticks can cost $1 or more, the testing can be a financial burden for some people as well, he said.

Newman said it can also be a “struggle” to get people to bring in the results of their finger prick testing.

While some testing devices work well with smartphones, others don’t, he said. So people have to bring in their testing meters to get that information downloaded, “which is inconvenient to the patient.”

Newman is not sure if Wang’s device could be an effective daily monitor. But he said It could be useful for a patient to know if they should be seen immediately, for example, if they’ve developed a condition such as diabetic ketoacidosis.

“I think it’s all about convenience. Anything we can do to make diabetes care more convenient, is a big win for the patient and provider,” Newman said.

For her part, Wang said she’d welcome working with area doctors to refine her diabetes monitor.

She adds that nanosensors may also find other applications, such as in cancer detection or for monitoring air or water pollution.

“There’s lots of (potential) applications,” Wang said.

Diabetes by the numbers

According to the Centers for Disease Control’s 2017 National Diabetes Statistic Report:

  • About 30.3 million people of all ages, or 9.4 percent of the U.S. population, had diabetes in 2015. That total includes 30.2 million adults (ages 18 and older), or 12.2 percent of all U.S. adults, of which 7.2 million didn’t know they had diabetes or didn’t report it.
  • The percentage of adults with diabetes increases with age, hitting 25.2 percent for those 65 years old or older.
  • American Indians and Alaska Natives had the highest prevalence of diagnosed diabetes for men (14.9 percent) and women (15.3 percent.)
  • The prevalence of diabetes varies by education level, which is an indicator of socioeconomic status, the CDC reported. About 12.6 percent of adults with less than a high school education had diagnosed diabetes, versus 9.5 percent of those with a high school education and 7.2 percent with more than a high school education.
  • Counties in the southern and Appalachian regions of the U.S. tend to have the highest prevalence of diagnosed diabetes.

What is diabetes

  • Type 1 diabetes, once known as juvenile diabetes, is a chronic condition in which the pancreas produces little or no insulin, the Mayo Clinic reports. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy.

Different factors, including genetics and some viruses, may contribute to Type 1 diabetes. Although Type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. There is no cure and treatment focuses on managing blood sugar levels with insulin, and diet and lifestyle changes to prevent complications.

Symptoms can appear suddenly and include: increased thirst, frequent urination, bed-wetting in children who previously didn't wet the bed at night, extreme hunger, unintended weight loss, irritability and other mood changes, fatigue and weakness, and blurred vision.

  • Type 2 diabetes is the most common version of diabetes, the American Diabetes Association reports. With Type 2 diabetes, your body either resists the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels.

Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity. Losing weight, eating well and exercising can help manage the disease. If diet and exercise don't manage your blood sugar well, you may also need medications or insulin.

  • Gestational diabetes develops during pregnancy. Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health, the Mayo Clinic said. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep mother and child healthy. Blood sugar levels usually return to normal soon after delivery, though someone who has had gestational diabetes is at risk for Type 2 diabetes, the Mayo Clinic reports.