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Table 1 Biomarkers used in relation to T2DM

From: Future detection and monitoring of diabetes may entail analysis of both β-cell function and volume: How markers of β-cell loss may assist

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]

  1. *BIPED (B urden of disease, I nvestigative, P rognostic, E fficacy of intervention, D iagnostic).