Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus

Abstract

Purpose of review: Diabetes mellitus is a complex, chronic illness characterized by elevated blood glucose levels that occurs when there is cellular resistance to insulin action, pancreatic β-cells do not produce sufficient insulin, or both. Diabetes prevalence has greatly increased in recent decades; consequently, it is considered one of the fastest-growing public health emergencies globally. Poor blood glucose control can result in long-term micro- and macrovascular complications such as nephropathy, retinopathy, neuropathy, and cardiovascular disease. Individuals with diabetes require continuous medical care, including pharmacological intervention as well as lifestyle and dietary changes.

Recent findings: The most common form of diabetes mellitus, type 2 diabetes (T2DM), represents approximately 90% of all cases worldwide. T2DM occurs more often in middle-aged and elderly adults, and its cause is multifactorial. However, its incidence has increased in children and young adults due to obesity, sedentary lifestyle, and inadequate nutrition. This high incidence is also accompanied by an estimated underdiagnosis prevalence of more than 50% worldwide. Implementing successful and cost-effective strategies for systematic screening of diabetes mellitus is imperative to ensure early detection, lowering patients' risk of developing life-threatening disease complications. Therefore, identifying new biomarkers and assay methods for diabetes mellitus to develop robust, non-invasive, painless, highly-sensitive, and precise screening techniques is essential. This review focuses on the recent development of new clinically validated and novel biomarkers as well as the methods for their determination that represent cost-effective alternatives for screening and early diagnosis of T2DM.

Keywords: Biomarkers; Enzymatic methods; Glycemia; Screening; T2DM.

Fig. 1

A Graphical representation of the mechanism by which glycated proteins and fructosamine correlate to hyperglycemia. B Kidney reuptake of 1,5-anhydroglucitol and glucose under normoglycemia and hyperglycemia. Abbreviations: 1,5-AHG, 1,5-anhydroglucitol; SGLT, sodium-glucose linked transporter. (Created with BioRender)

Fig. 2

Model representing the relationship between impaired energy metabolism and biomarkers for the screening and diagnosis of type 2 diabetes mellitus. Abbreviations: 1,5-AHG, 1,5-anhydroglucitol; BCAAs, branched-chain amino acid; α-HB, α-hydroxybutyrate; L-GPC, linoleoylglycerophosphocholine; LysoPC, lysophosphatidylcholine; mTOR, mammalian target of rapamycin. (Created with BioRender)