Blood marker might predict early onset of diabetes

When doctors need to administer an early-detection diabetes test, they have only a few options.

The widely used "finger prick technique," in which doctors measure their patients' immediate sugar levels, is easy to perform, but cannot detect pre-diabetes. The remaining tests require patients to fast prior to coming to the doctor's office and are often administered too late to prevent full-blown diabetes.

There is an urgent need for the development of a new pre-diabetes test, as patients whose diabetes is caught early can delay or prevent illness onset by altering their diet and exercise habits.

A Hopkins research team recently found a biomarker for diabetes, which may lead to a new assay for the disease. The researchers focused on a complex sugar called O-linked N-acetylglucosamine (O-GlcNAc), which is made from the much simpler sugar, glucose.

O-GlcNAc helps to modulate protein expression in response to nutrient and stress levels. The researchers found that O-GlcNAc affects insulin resistance and is up-regulated at certain sites on red blood cells proteins.

Checking patients' O-GlcNAc levels may someday provide a quick, efficient test for early-stage diabetes.

"Once developed, the immunoassay for site-specific changes in O-GlcNAc would not only be a routine and simple blood test, but also has the potential to catch the onset of the disease," said researcher Gerald Hart of the Hopkins School of Medicine.

According to the American Diabetes Association, there are 23.6 million diabetic children and adults in the United States - close to eight percent of the population. Though there are multiple types of diabetes, all diabetics have problems producing or using insulin properly.

Because insulin, a hormone produced in the pancreas, tells the body to remove glucose from the blood and store it in cells, untreated diabetics have too much blood glucose and no way of getting energy to their cells.

Diabetes is easy to diagnose once the disease has progressed, but early detection is much more challenging. The research team has hope, however, that measuring patients' O-GlcNAc levels may someday provide a useful test for early-stage diabetes.

"While the potential of this diagnostic assay is high, we have a long way to go to prove its usefulness clinically," Hart said. The team hopes to conduct larger trials to validate their discovery.