Simple blood test could detect who will develop type 2 diabetes years before diagnosis
A decades-long study into key markers in the blood could pave the way for a simple blood test that can detect diabetes years before symptoms appear, researchers say.
US scientists identified 235 molecules in the blood that are associated with type 2 diabetes over a 26-year follow up.
The findings could allow for the condition to be spotted earlier, slashing the risk of subsequent complications, such as heart disease, kidney failure and stroke.
Around 589million people worldwide are thought to be living with diabetes – with 90 per cent of cases being type 2.
Obesity is thought to be the main trigger, with exercise and diet help mediating the risk of developing the condition. But scientists now think it’s not all about losing weight.
Type 2 diabetes develops when the body doesn’t produce enough insulin, or becomes resistant to its effects, causing glucose to build up in the bloodstream.
Diabetes is currently diagnosed after it develops through a blood or urine test, which detects high blood sugar levels.
Previous research has identified more than 100 blood molecules produced through metabolism – called metabolites – that have been linked with the chronic disease.
Experts say there are tell-tale markers in a person’s blood that could predict diabetes years before diagnosis
Changes in people’s metabolic profiles reflect and drive disease; when organs stop working properly, the profile will begin to change.
In type 2 diabetes, blood glucose levels rise uncontrollably – but up until now, how genetic and environmental risk factors interact has been unclear.
In the study, researchers from Mass General Brigham and Albert Einstein College of Medicine, New York, analysed blood samples from 23,634 initially diabetes-free participants from 10 different studies, over a follow-up period of 26 years.
The team also analysed genomic and lifestyle data, to ascertain which blood markers were genetic and which resulted from environmental stressors.
In total, the researchers studied 469 circulating metabolites and found 235 could be linked with type 2 diabetes. Of these, 67 were newly identified in this study.
Notably, the observed link between these blood markers and type 2 diabetes reamined, even when known risk factors such as obesity, high cholesterol, blood pressure, physical inactivity and poor diet were taken into account.
During the follow-up, 4,000 participants were diagnosed with type 2 diabetes.
Genetic analyses showed that many of these metabolites are connected to key biological pathways involved in diabetes – such as insulin resistance, fat distribution, liver function and inflammation.
Almost 4.3 million people were living with diabetes in 2021/22, according to the latest figures for the UK
But, the researchers also found that lifestyle factors including weight, physical activity and diet can also strongly influence these circulating metabolites.
For example, excess body fat was shown to push the body towards a diabetic state, years before symptoms develop as a result of changes in metabolites linked to fat storage, fat metabolism and insulin resistance.
Leading an active lifestyle, however, was shown to shift metabolites the other way, improving fat metabolism, live function and insulin sensitivity.
Metabolites linked to coffee and tea intake were also found to have a protective effect, resulting in better glucose response and reduced liver fat.
The researchers concluded, therefore that lifestyle factors like diet and exercise don’t just affect weight and blood sugar – they alter the body’s metabolic profile, which then influences diabetes risk.
Using this information, the team developed a risk-score that they say can predict future diabetes risk than traditional methods like body weight or blood glucose alone.
Publishing their findings in the scientific journal Nature, the researchers said: ‘Our metabolic signature may serve as a powerful tool for risk stratification and as a monitoring biomarker to inform type 2 diabetes prevention and early intervention.’
However, the researchers flagged, because of the observational study design they could not determined whether diabetes was directly caused by these changes.
In the UK, diabetes is the fastest-growing health crisis, with rising obesity driving a 39 per cent increase in type 2 diabetes among under-40s.
The findings align with a recent study which found that a regular cup of coffee could be more effective at controlling blood sugar than acarbose, a commonly prescribed diabetes drug that works by slowing the breakdown of carbohydrates after meals.
They found that coffee inhibited the same digestive enzyme targeted by the drug, helping blunt spikes in blood sugar following food.
Researchers say the finding could eventually benefit people with type 2 diabetes, who rely on regular injections and medication to keep their blood sugar stable.
