---
title: "Breath analysis for detecting glucose metabolism disturbances: clinical applicability review"
id: "pubmed-42727601"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42727601"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42727601/"
doi: "10.1088/1752-7163/aea638"
published_at: "2026-09-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Breath analysis for detecting glucose metabolism disturbances: clinical applicability review
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42727601
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42727601/)
- **DOI:** [10.1088/1752-7163/aea638](https://doi.org/10.1088%2F1752-7163%2Faea638)
- **Published At:** 2026-09-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This systematised review assessed the clinical applicability of **breath analysis** to detect disturbances in systemic glucose metabolism including diabetes, prediabetes, insulin resistance, gestational diabetes, hypoglycaemia, and for blood glucose estimation. - A structured PubMed search identified human studies published between 2010 and 2025; **30 studies** met inclusion criteria. - Most studies measured **volatile organic compounds (VOCs)** using laboratory platforms such as **gas chromatography–mass spectrometry (GC-MS)** or **proton transfer reaction–mass spectrometry (PTR-MS)**. - A growing number of investigations used portable, sensor-based systems including electronic noses and single-gas sensors; a smaller subgroup used **isotope-based** breath tests that measure labelled CO2 after substrate ingestion. - Reported diagnostic performance was highest and most consistent for **hypoglycaemia** detection in type 1 diabetes (sensitivity and specificity approximately 90%–95%). - **Isotope-based** breath tests reported discrimination of prediabetes and diabetes subtypes with reported accuracy around 90%–100%, but these results stem from a single research group and require independent replication. - Qualitative detection of diabetes and quantitative **blood glucose** prediction showed variable performance across studies and platforms. - Multivariable and spectral approaches that capture signal complexity outperformed single-compound methods. - Major methodological limitations were common: small cohorts, internal validation only, poor standardisation of sampling and reporting, and heterogeneity of analytical platforms. - The authors conclude that standardised protocols, larger externally validated cohorts, and careful platform selection matched to the intended clinical role are required before clinical implementation.
## Clinical Analysis & Structured Key Points
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[ Full text links ](https://pubmed.ncbi.nlm.nih.gov/42727601/) ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42727601/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Experimental Resource Linked Discoveries ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42727601/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42727601/#abstract) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42727601/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42727601/#mesh-terms) * [ Substances ](https://pubmed.ncbi.nlm.nih.gov/42727601/#substances) * [ LinkOut - more resources ](https://pubmed.ncbi.nlm.nih.gov/42727601/#linkout) Title & authors Abstract Publication types MeSH terms Substances LinkOut - more resources Review J Breath Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Breath+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Breath+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42727601/) . 2026 Sep 28;20(4). doi: 10.1088/1752-7163/aea638. # Clinical applicability of breath measurements for detecting disturbances in systemic glucose metabolism: a systematised review [Ben Marino Scattolo](https://pubmed.ncbi.nlm.nih.gov/?term=Scattolo+BM&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland."), [Cléo Nicolier](https://pubmed.ncbi.nlm.nih.gov/?term=Nicolier+C&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland."), [Maria Luisa Balmer](https://pubmed.ncbi.nlm.nih.gov/?term=Balmer+ML&cauthor_id=42727601)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-3 "Institute for Infectious Diseases, University of Bern, Bern, Switzerland."), [Lilian Witthauer](https://pubmed.ncbi.nlm.nih.gov/?term=Witthauer+L&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#full-view-affiliation-4 "Department for Digital Medicine, University of Bern, Bern, Switzerland.") Affiliations Expand ### Affiliations * 1 Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. * 2 Diabetes Center Berne, Bern, Switzerland. * 3 Institute for Infectious Diseases, University of Bern, Bern, Switzerland. * 4 Department for Digital Medicine, University of Bern, Bern, Switzerland. * PMID: **42727601** * DOI: [ 10.1088/1752-7163/aea638 ](https://doi.org/10.1088/1752-7163/aea638) Item in Clipboard Review # Clinical applicability of breath measurements for detecting disturbances in systemic glucose metabolism: a systematised review Ben Marino Scattolo et al. J Breath Res. 2026. Show details Display options Display options Format Abstract PubMed PMID J Breath Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Breath+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Breath+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42727601/) . 2026 Sep 28;20(4). doi: 10.1088/1752-7163/aea638. ### Authors [Ben Marino Scattolo](https://pubmed.ncbi.nlm.nih.gov/?term=Scattolo+BM&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland."), [Cléo Nicolier](https://pubmed.ncbi.nlm.nih.gov/?term=Nicolier+C&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland."), [Maria Luisa Balmer](https://pubmed.ncbi.nlm.nih.gov/?term=Balmer+ML&cauthor_id=42727601)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-3 "Institute for Infectious Diseases, University of Bern, Bern, Switzerland."), [Lilian Witthauer](https://pubmed.ncbi.nlm.nih.gov/?term=Witthauer+L&cauthor_id=42727601)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-1 "Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-2 "Diabetes Center Berne, Bern, Switzerland.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42727601/#short-view-affiliation-4 "Department for Digital Medicine, University of Bern, Bern, Switzerland.") ### Affiliations * 1 Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. * 2 Diabetes Center Berne, Bern, Switzerland. * 3 Institute for Infectious Diseases, University of Bern, Bern, Switzerland. * 4 Department for Digital Medicine, University of Bern, Bern, Switzerland. * PMID: **42727601** * DOI: [ 10.1088/1752-7163/aea638 ](https://doi.org/10.1088/1752-7163/aea638) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Breath analysis is a candidate non-invasive approach for detecting disturbances in glucose metabolism, but its clinical applicability has not been systematically assessed across analytical platforms and clinical targets. This systematised review evaluates breath-based biomarkers and analytical technologies for the detection of diabetes, prediabetes, insulin resistance, gestational diabetes, and hypoglycaemia, and for blood glucose estimation. A structured PubMed search identified human studies published between 2010 and 2025; 30 studies met the inclusion criteria. Most analysed volatile organic compounds using laboratory platforms such as gas chromatography-mass spectrometry (MS) or proton transfer reaction MS, a growing number used portable sensor-based systems including electronic noses and single-gas sensors, and a smaller group used isotope-based breath tests measuring labelled carbon dioxide after substrate ingestion. Reported diagnostic performance was highest and most consistent for hypoglycaemia detection in type 1 diabetes mellitus (sensitivity and specificity approximately 90%-95%) and for isotope-based discrimination of prediabetes and diabetes subtypes (approximately 90%-100%), whereas qualitative diabetes detection and quantitative blood glucose prediction were more variable. Both findings are based on a small number of studies, and the isotope-based results originate from a single research group and require independent replication. Performance depended strongly on signal complexity, with multivariable and spectral approaches outperforming single-compound methods. However, most studies used small cohorts and internal validation only, and sampling procedures and reporting were poorly standardised. Standardised protocols, larger externally validated cohorts, and platform selection matched to the intended clinical role are required before implementation. **Keywords:** breath analysis; diabetes mellitus; electronic nose; metabolic biomarkers; non-invasive diagnostics; volatile organic compounds. Creative Commons Attribution license. 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