Predictive biomarkers for diabetes progression
Accumulating evidence indicates that type 2 diabetes can be prevented through diet changes and physical exercise. However, the significant variation in individuals' response to these interventions makes it difficult to identify individuals at risk of developing diabetes. Currently, glucose is the only accepted biomarker for diabetes. However, its levels change at the last stages in the physiological progression to disease, resulting in late diagnosis. The EU-funded DEXLIFE (Mechanisms of prevention of type 2 diabetes by lifestyle intervention in subjects with pre-diabetes or at high-risk for progression) project tackled this problem through the identification of biomarkers of disease progression. These predict the transition from a state of normal metabolism with normal glucose tolerance through to pre-diabetes followed by type 2 diabetes. To assess this evolution to diabetes in the population, DEXLIFE partners investigated four different cohorts and one new prospective longitudinal study. Data relating to their clinical phenotype, the metabolome/lipidomic profile, transcriptomic, epigenetic and genetic data were collected and evaluated. The idea was to find environmental risk factors and biomarkers related to different stages of type 2 diabetes capable of predicting the relevant clinical endpoints. Researchers identified novel metabolite markers, which are significantly decreased or increased following diet and exercise interventions. In the intervention study, lifestyle changes led to significant changes in individual physiology, health and glucose levels, clearly indicating the value of lifestyle choices in metabolic balance. DEXLIFE developed a personalised intervention model using a systems biology approach. This can be used in screening programmes to identify individuals at high risk and people not yet diagnosed with diabetes. Nine publications have been accepted by peer-reviewed journals, and eight publications are under preparation. Information on the novel biomarkers has been presented at international conferences. Diagnostic kits that measure the biomarkers identified by DEXLIFE and that outline personalised intervention regimes could well be a commercialised product arising from these research results. Consumer education on avoidance of diabetes risk could also be improved by including this new information. Future health policy overall could make significant progress in prevention of diabetes in high-risk individuals.
Keywords
Predictive markers, type 2 diabetes, DEXLIFE, glucose intolerance, metabolite
