New research suggests the current way of diagnosing type 2 diabetes should be changed to help prevent patients from experiencing poorer health outcomes.
Findings from a long-term UK study, published online in the journal PLOS ONE, show that by the time most patients have been diagnosed using their blood glucose level, the body’s blood vessels may already be damaged.
Many of the serious long-term diabetes complications develop from blood vessel damage, as this can cause affected organs, such as the heart, the nerves, the eyes and the kidneys, to stop functioning effectively.
Scientists from The University of Manchester and King’s College London analysed biochemical markers in the blood of young women with different risks of developing type 2 diabetes before the level of glucose in their blood became elevated (or before they reached the prediabetes stage).
They found that changes in types of blood fat metabolites (particles that come make up fats in the blood) could be detected way before changes in blood glucose that now define prediabetes or type 2 diabetes, and therefore appear to be good indicators of developing the metabolic disorder.
“We found that several groups of fat metabolites, also linked to body fat, were changed in the blood, as were others including some amino acids and to some extent vitamin D, before glucose levels increased,” explained Professor Kennedy Cruickshank, lead author of the study.
“Blood vessels become damaged as part of the condition, but problems in the vessels arise before high blood sugar sets in during a ‘prediabetes’ period. The current method of categorising type-2 diabetes solely by a patient’s glucose level means that many will already have suffered blood vessel damage and will experience poorer outcomes.

He added that the study findings support the argument that a new, relatively different definition of type 2 diabetes is required – one partly based on the distribution of blood fat metabolites in the prediabetes stage, instead of purely blood glucose – to improve blood vessel health.
Study co-author, Dr Simon Anderson, commented: “To help clarify the metabolic conditions that lead to the development of type 2 diabetes, further assessment of the total chemicals in the blood – the metabolome – is necessary.

“In the long-term we aim to identify a biomarker or a disorder in a chemical pathway that is linked to blood vessel health and subsequent diabetes. Ultimately this might translate into a specific blood test to identify people at risk of type 2 diabetes early on but most importantly, it may allow advice on lifestyle modification at an earlier stage to reduce the long-term impact of diabetes.”

The authors said further research is now needed to confirm this alternative approach to diagnosing, treating and preventing type 2 diabetes.

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