Glycated nail proteins: a new approach for detecting diabetes in developing countries

Objective To assess glycation of nail proteins as a tool in the diagnosis of diabetes. Methods Glycation of nail proteins was assessed using a modified photometric nitroblue tetrazolium‐based assay, which provides information about average glucose values of the last 6–9 months. Analysis is possible on 10 mg of nail clippings with a within‐run coefficient of variation ( CV ) of 11%. The analyte is extremely stable. The reference range for glycated nail protein (0.55–3.60 μmol/g nail) increases upon ageing. Results In diabetics ( n  = 112), values for glycated nail protein are significantly higher (median: 4.07 μmol/g nail, IQR : 2.37–6.89 μmol/g nail, P  < 0.0001) than in non‐diabetics ( n  = 116). ROC analysis shows an AUC of 0.848 (specificity 93.1%; sensitivity 68.9%). Conclusion This affordable method is a simple alternative for diagnosing diabetes in remote areas as the pre‐analytical phase (including all processes from the time a laboratory request is made by a physician until the sample is ready for testing) is extremely robust.