The story so far: India has one of the highest burdens of Non-Communicable Diseases (NCDs) globally, with over 100 million people living with diabetes and another 136 million classified as pre-diabetic. Despite this, most diagnoses still rely on conventional tools and tests which often detect the disease only after significant damage has occurred. A new study published in the Journal of Proteome Research by researchers from IIT Bombay, Osmania Medical College, and Clarity Bio Systems suggests that tiny molecules in blood, known as metabolites, could serve as early warning signals for diabetes and its complications, particularly kidney disease.
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What are biochemical markers?
Biochemical markers are small molecules produced during metabolic processes in the body. These include sugars, amino acids, lipids, and other compounds that reflect the state of various organs and systems. Metabolomic profiling, the large-scale study of these molecules, allows researchers to detect subtle changes in the body’s chemistry that may precede disease. Using advanced techniques like liquid chromatography and mass spectrometry, scientists can analyse hundreds of metabolites from a single blood sample.
In the recent study, researchers used dried blood spots, a simple finger-prick method, to collect samples from 52 individuals, including healthy participants, diabetics, and those with diabetic kidney disease (DKD). They found distinct patterns in the levels of certain metabolites that could help identify disease risk earlier than usual tests.
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What did the study find?
The study identified 26 metabolites that differed significantly between healthy individuals and those with diabetes. These included expected markers like glucose and cholesterol, but also lesser-known compounds such as valerobetaine, ribothymidine, and fructosyl-pyroglutamate. Among those with kidney complications, seven metabolites — including arabitol, myo-inositol, and 2PY — showed a progressive increase from healthy to diabetic to DKD stages. Sneha Rana, the study’s first author and a Ph.D scholar in Professor Pramod Wangikar’s lab at IIT Bombay, explained, “Type 2 diabetes is not just about high blood sugar; it disrupts multiple metabolic pathways that standard tests often miss.”
The study also revealed two distinct subgroups among diabetics. One group had metabolic profiles closer to healthy individuals, while the other showed pronounced changes in markers related to stress, inflammation, and energy metabolism.
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Why is this important for India?
According to the Indian Council of Medical Research – India Diabetes survey, 11.4% of adults have diabetes and 15.3% are pre-diabetic. The country also faces high rates of hypertension, obesity, and other metabolic risk factors. Yet, more than 80% of people with NCDs remain undiagnosed or inadequately treated. Early detection tools like metabolomic profiling could be transformative. By identifying disease risk before symptoms appear or organs are damaged, healthcare providers can intervene earlier, potentially preventing complications such as kidney failure, heart disease, and nerve damage. If validated in larger studies, metabolomic markers could be used to develop low-cost, field-friendly tests for early screening. The use of dried blood spots makes sample collection easy and scalable, especially in rural and underserved areas.
Moreover, metabolomic profiling could enable personalised care. Patients could be grouped based on their metabolic profiles, allowing doctors to tailor interventions, from lifestyle changes to medication, based on individual risk.
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Are there limitations to this approach?
While the findings are promising, the study had a small sample size and needs to be replicated across larger and more diverse populations. Translating metabolomic data into clinical practice also poses challenges, including standardising lab protocols, ensuring regulatory approvals, and making the technology accessible. Mass spectrometry, the technique used to analyse metabolites, is expensive and not widely available outside research settings. Developing affordable versions of these tests will be crucial for widespread adoption.
Researchers are planning larger cohort studies to validate these findings and explore how metabolomic markers perform across different age groups, ethnicities, and comorbidities. If successful, India could lead the way in integrating metabolomics into routine healthcare, shifting from reactive treatment to proactive prevention.
Published – November 09, 2025 01:48 am IST
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