Biomarkers in diabetes mellitus: Advancements, challenges, and future perspectives

Abstract

Diabetes mellitus (DM) represents a multifaceted metabolic disorder characterized by hyperglycemia and dysregulated metabolism, stemming from a myriad of factors including insulin insufficiency and impaired glucose utilization. Its complications span a broad spectrum, encompassing vascular diseases and neurological impairments. While some risk factors are beyond control, such as age and genetics, others like diet and exercise offer avenues for risk mitigation. This review delineates the distinct pathogenic processes of the two primary forms of DM, type 1 and type 2, emphasizing their differential etiologies and epidemiological trends. Biomarkers play a pivotal role in the diagnosis and management of DM, offering insights into disease progression, beta-cell function, and therapeutic responses. Traditional biomarkers, alongside predictive markers like autoantibodies, facilitate early detection and intervention strategies. Moreover, advancements in high-throughput "-omics" technologies have unraveled the molecular intricacies underlying disease progression, heralding the discovery of potential serum protein biomarkers in type 1 DM and unveiling promising candidates such as unmethylated insulin DNA and dysregulated microRNAs. In type 2 DM, traditional biomarkers like fructosamine, glycated albumin, and 1,5-anhydroglucitol offer valuable tools for glycemic control assessment, with emerging biomarkers like zinc-alpha-2-glycoprotein holding promise for diabetic nephropathy detection. Despite challenges, ongoing research endeavors hold promise for refining these biomarkers and enhancing diabetes management strategies, thus improving patient outcomes.