Facebook PixelUsing taste sensitivity to diagnose and detect the severity of hyperglycemia (type 2 diabetes)
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Using taste sensitivity to diagnose and detect the severity of hyperglycemia (type 2 diabetes)

Image credit: Photo by Andrea Piacquadio from Pexels

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 07, 2020
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Taste sensitivity is the minimum concentration at which a person is able to perceive a specific taste - sweet, sour, salty, bitter, and umami.

Type 2 diabetes mellitus (T2DM) patients show an impairment of the taste sensation, mostly for the sweet sensation compared to other tastes. The decrease in sensitivity or the increase in the taste threshold is associated with hyperglycemia (higher than normal blood glucose concentration). Moreover, it was found that fasting blood glucose values induced a blood glucose-dependent increase in the detection and recognition of taste thresholds to sweetness. The current range of this association is between 140 mg/dL (normal fasting values are up to 100 mg/dL) and 300 mg/dL. Further investigation is needed to expand this range to accommodate normoglycemic values on one hand and overtly hyperglycemic values on the other. Significant differences were also observed in the detection and recognition of taste thresholds between normoglycemic and hyperglycemic diabetics, in terms of their HbA1C values. Furthermore, differences in taste sensitivity were also useful in distinguishing between normoglycemic, pre-diabetic, and diabetic populations.

On the contrary, a recent study demonstrated a very low specificity of HbA1C (a biomarker of the severity of hyperglycemia) when compared to an oral glucose tolerance test for identifying pre-diabetes. HbA1C is usually used to diagnose diabetes and it is also used to decide the medication regime. Taste sensitivity may serve as a better complementary or supplementary marker. The other advantage of using taste sensitivity is its non-invasiveness (compared to blood glucose measurement).

[1]Lawson WB, Zeidler A, Rubenstein A. Taste Detection and Preferences in Diabetics and their Relatives. Psychosom Med [Internet]. 1979 May;41(3):219–27. Available from: http://journals.lww.com/00006842-197905000-00005

[2]Chochinov RH, Ullyot GLE, Moorhouse JA. Sensory Perception Thresholds in Patients with Juvenile Diabetes and Their Close Relatives. N Engl J Med [Internet]. 1972 Jun 8;286(23):1233–7. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM197206082862303

[3]Khobragade RS, Wakode SL, Kale AH. Physiological taste threshold in type 1 diabetes mellitus. Indian J Physiol Pharmacol [Internet]. 56(1):42–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23029963

[4]Gondivkar SM, Indurkar A, Degwekar S, Bhowate R. Evaluation of gustatory function in patients with diabetes mellitus type 2. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology [Internet]. 2009 Dec;108(6):876–80. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1079210409006210

[5]Bustos-Saldaña R, Alfaro-Rodríguez M, Solís-Ruiz M de la L, Trujillo-Hernández B, Pacheco-Carrasco M, Vázquez-Jiménez C, et al. [Taste sensitivity diminution in hyperglycemic type 2 diabetics patients]. Rev Med Inst Mex Seguro Soc [Internet]. 47(5):483–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20550856

[6]Wasalathanthri S, Hettiarachchi P, Prathapan S. Sweet taste sensitivity in pre-diabetics, diabetics and normoglycemic controls: a comparative cross sectional study. BMC Endocr Disord [Internet]. 2014 Dec 13;14(1):67. Available from: https://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-14-67

[7]Vlaar EM, Admiraal WM, Busschers WB, Holleman F, Nierkens V, Middelkoop BJ, et al. Screening South Asians for type 2 diabetes and prediabetes: (1) comparing oral glucose tolerance and haemoglobin A1c test results and (2) comparing the two sets of metabolic profiles of individuals diagnosed with these two tests. BMC Endocr Disord [Internet]. 2013 Dec 25;13(1):8. Available from: https://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-13-8

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Creative contributions

A device that could measure the taste sensitivity much faster and smarter

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jnikola
jnikola Dec 27, 2021
When I read your idea, I wasn't very convinced that it could work. What I focused on the most were the two techniques they used to evaluate the taste sensitivity: a whole-mouth, above-threshold taste test, and a spatial (localized) taste test. Both of these tests require a patient to taste the diluted sample and rate it on a personal opinion scale. Although patients were specifically chosen to match multiple criteria, I still thought about how primitive these methods are and forgot how excellent this idea is.
Recently, I read interesting news that reminded me of this, so I wanted to propose an upgrade. The researchers invented the Tasty TV - a device that can give users the taste of what it's on TV. It contains sprays with various tastes that are combined to create a wide spectrum of different tastes.
My idea was to create a tool that would help record the taste changes between the groups of patients that you mentioned in the session's text. It would automatically generate different tastes which are found to be impaired in certain disorders. The computer would provide a visual interface where the patient could decide which flavor is he/she experiencing in terms of words, pictures, etc. It would be recorded and fed into an algorithm that detects traits of disorders. It could be applied to senses of smell, too.
Does it sound better than series of drinkable samples used in the papers mentioned in the session?
If you have any upgrade or another interesting use or application of the Tasty TV, I'd be happy to hear :)
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Shubhankar Kulkarni
Shubhankar Kulkarni3 years ago
Hi J. Nikola ! Thank you for sharing the upgrade. The Tasty TV looks great! I think what you propose is much easier than the existing taste sensitivity tests. The Tasty TV can give you a tasty sample and ask you a series of questions regarding it. Based on your response, it will diagnose your condition. I, therefore, think you do not need two different groups for evaluation. What do you think?
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jnikola
jnikola3 years ago
Shubhankar Kulkarni That's true. Then the TV (or we should better call it the Tasty PC) needs to be "trained".
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General comments

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Darko Savic
Darko Savic4 years ago
I'm thinking about Synsepalum dulcificum again. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747512/ What if people with diabetes used chewing gum laced with Synsepalum dulcificum extract. In theory, because of it, everything would taste too sweet to them so they would reduce consumption of such foods.
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Shubhankar Kulkarni
Shubhankar Kulkarni4 years ago
I think this might work to an extent. What I read in the references mentioned with the session is that the sensitivity to sweet taste decreases in diabetics. Therefore, they require sweeter foods to perceive the same level of sweetness that a healthy person would. I hope using Synsepalum dulcificum does not aggravate their disease by speeding their loss of sensitivity to sweetness.
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Darko Savic
Darko Savic4 years ago
From my experience with Synsepalum dulcificum, whatever is sweet, thereafter tastes inedibly sweet. Sour tastes pleasantly sweet. For example, a lemon tastes like an orange.
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