Towards metabolic biomarkers of insulin resistance and type 2 diabetes: progress from the metabolome.

The complex aetiology of type 2 diabetes makes effective screening, diagnosis and prognosis a substantial challenge for the physician. The rapidly developing area of metabolomics, which uses analytical techniques such as mass spectrometry and nuclear magnetic resonance, has emerged as a promising approach to identify biomarkers of diabetes and the insulin-resistant state that precedes overt pathology. Initial successes with metabolomic studies have indicated potential biomarkers for insulin resistance and for identifying people at risk of developing diabetes, with particular focus on aminoacids and lipid metabolism. These biomarkers will help to improve research and management of diabetes. In particular, several biomarkers identified could be used for early identification of diabetes risk. Furthermore, changes in selected biomarkers can indicate effectiveness of therapeutic interventions for type 2 diabetes and the metabolic syndrome. Indeed, there is much promise that branched-chain aminoacids might provide a screening biomarker for type 2 diabetes risk, allowing early dietary and exercise interventions to treat or even prevent the disease.