Potential Molecular Biomarkers for Predicting and Monitoring Complications in Type 2 Diabetes Mellitus

According to the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC), type 2 diabetes mellitus (T2DM) remains a major public health issue with a considerable impact on human life, affecting over 38 million Americans of all ages, and an estimated 529 million people worldwide. It is a significant risk factor for polyneuropathy, eye problems, coronary artery disease (CAD), renal disease, heart disease, stroke, and peripheral artery disease (PAD). Nearly 9 million Americans with diabetes are unaware of their condition and, therefore, do not receive health care to prevent disease progression and complications. With T2DM being a condition that leads to increased demand for health care services due to its long-term, persistent nature and its incremental impact on the body, early diagnosis and timely initiation of effective treatments are essential. Despite the effect of metabolic memory in the development of diabetes-related complications, early intervention helps decelerate disease progression, reduce complications, and ultimately improve survival. Various blood-based biomarkers have been identified, which hold great promise to streamline the mechanisms underlying T2DM and its progression from insulin resistance and prediabetes to diabetes and end-stage diabetes. However, the greatest need is to identify and utilize reliable biomarkers that can help to assess pharmacological treatment response and guide efforts to improve insulin sensitivity, preserve pancreatic beta-cell function, and prevent or delay complications. This review explores the clinical utility of promising biomarkers and assess their potential to support more personalized pharmacological approaches tailored to the individual characteristics of T2DM patients.