Biomarker | Target | Change in T2DM | Advantages | Disadvantages | Examples of BIPED* classification |
---|---|---|---|---|---|
HbA1C | Blood glucose | Elevated | Easy and fast to measure. | B, D: | |
No restrictions prior to measurement. | Used as the Gold standard for diagnosis and monitoring of T2DM[29] | ||||
E: HbA1C↓ | |||||
Sulphonylureas+ Rosaglitazone[53] | |||||
Prioglitazone[54] | |||||
Balaglitazone and Pioglitazone[55] | |||||
Liraglutide and Sitagliptin[56] | |||||
DDP-IV inhibitor LC 15–0444[57] | |||||
Fasting plasma glucose (FPG) | Blood glucose | Elevated | Easy and fast to measure. | Require patients to be fasting prior to sampling | B, D: |
Used in the diagnosis and monitoring of T2DM[29] | |||||
E: FPG ↓ | |||||
Sulphonylureas+ Rosaglitazone[53] | |||||
Prioglitazone[54] | |||||
Balaglitazone and Pioglitazone[55] | |||||
Liraglutide and Sitagliptin[56] | |||||
DDP-IV inhibitor LC 15–0444[57] | |||||
Oral glucose tolerance test (OGTT) or Post-prandial glucose | Blood glucose clearance | Glucose clearance: Impaired | OGTT: Accurate assessment of functional glucose clearance by liver or peripheral tissues | Two hour test. | B, D: |
Used in the diagnosis and monitoring of T2DM[29] | |||||
Post prandial glucose: Elevated | Post-prandial glucose: A less time-consuming method to assess glucose clearance than OGTT | Time consuming test for the patient. | E: Improved OGTT | ||
Prioglitazone[54] | |||||
E: Post prandial glucose ↓ | |||||
Balaglitazone and Pioglitazone[55] | |||||
Pro-insulin | Β-cell stress/dysfunction | Elevated | Only current marker to assess β-cell dysfunction | Usually combined with additional tests: Fasting insulin, C-peptide | E: pro-insulin ↓ |
Split pro-insulin | Proinsulin not directly influenced by therapeutic injections of insulin | Exenatide[58] | |||
Pro-insulin/Insulin ratio | E: Split pro-insulin ↓ | ||||
Prioglitazone[54] | |||||
E: Split pro-insulin → | |||||
Gliclazide[54] | |||||
E: pro-insulin/insulin ratio ↓ | |||||
Liraglutide and Sitagliptin[56] | |||||
Exenatide[58] | |||||
Fasting Insulin | Β-cell functionality | Elevated in early stages of disease development. | Short half life of insulin | Fasting insulin levels changes with the stages of pathogenesis of T2DM | E: Fasting Insulin ↑ |
Decreased in late stages of T2DM | Injections with insulin is used as treatment in T2DM | Gliclazide[54] | |||
Chlorpropamide[59] | |||||
Glibenclamide[59] | |||||
Insulin[59] | |||||
E: Fasting Insulin → | |||||
Exenatide[58] | |||||
Liraglutide and Sitagliptin[56] | |||||
E: Fasting Insulin ↓ | |||||
Sulphonylureas+ Rosaglitazone[53] | |||||
Prioglitazone[54] | |||||
Metformin[59] | |||||
C-peptide | Total insulin secretion | Elevated in early stages of disease development. | Half life: C-peptide | E: C-peptide ↓ | |
Decreased in late stages of T2DM | > Insulin. Improved assessment of total insulin secretion | Sulphonylureas+Rosaglitazone[53] | |||
C-peptide not directly influenced by therapeutic injections of insulin | Prioglitazone[54] | ||||
DDP-IV inhibitor LC 15–0444[57] | |||||
E: C-peptide ↑ | |||||
Liraglutide and Sitagliptin[56] | |||||
Gliclazide[54] |