A study published in The Lancet found changes in glucose concentrations, insulin sensitivity and insulin secretion can be detected as early as three to six years before diagnosis of diabetes. This new data may lead to more accurate risk prediction in regular check ups.
 
The metabolic markers included: fasting and postload glucose (the latter taken 2 hours after eating), insulin sensitivity and beta-cell function. The last two were assessed using a method called HOMA (short for Homeostatic Model Assessment), a way of calculating insulin resistance. Beta-cells are the cells in the pancreas that produce and release insulin.

The results of the study showed:

• All metabolic markers, except insulin secretion, showed a steady increase over the period of the study. 
•  Fasting glucose went up dramatically about three years before diagnosis of diabetes.
• The postload glucose measures rapidly increased about three years before diagnosis, and HOMA insulin sensitivity fell sharply five years before diagnosis.

Using these new markers could help further identify individuals at risk for developing diabetes in the future.

This article originally appeared in the July 2009 issue of Kidney Beginnings: The Electronic Newsletter.