Biomarkers in Exhaled Breath of Glucose Fluctuation in Type 1 Diabetes

The investigators aim through the use of proton-transfer-reaction mass spectrometry to
perform comprehensive breath analysis to identify compounds of interest associated with
glucose fluctuations. More than 500 different volatile organic compounds can be detected in
human breath. Compounds such as ethane, pentane and isoprene (hydrocarbons), as well as
acetone, acetaldehyde, methanol, ethanol, 2-propanol (oxygen-containing compounds), are most
likely to be relevant and measurable in our study population. Hydrocarbons are stable
end-products of lipid peroxidation and show only low solubility in blood and therefor are
excreted into breath within minutes of their formation in tissues. There is evidence for
increased hydrocarbon production in states of oxidative stress. Oxygen-containing compounds
such as acetone/acetaldehyde (ketones) are also clinically relevant in the measurement of
insulin deficient states of catabolism in patients with diabetes. A previous study of exhaled
isoprene was found to be elevated during hypoglycemia. This study aims to expand on this to
characterize the full range of changes in concentrations of volatile organic compounds in
human breath during glucose fluctuations.

Characterizing this "biochemical fingerprint" of hypoglycemia may provide clues about what
so-called diabetes alert dogs are detecting as well as improve our understanding of
hypoglycemia, the physiology behind hypoglycemia unawareness, and potentially identify a
novel non-invasive measure of blood glucose.

Inclusion Criteria:

- Have a diagnosis of type 1 diabetes

- No current or planned tobacco/nicotine use including vaping during the study

- Are not pregnant or planning to become pregnant during the study timeframe

Exclusion Criteria: