Geneva researchers have discovered a molecule which makes it possible to identify diabetes before the appearance of the first symptoms. A simple blood test followed by an inexpensive test would detect the disease and take action before the situation is irreversible.
In Switzerland, almost 500,000 people have diabetes. This metabolic disorder is constantly increasing under the joint effect of a lack of physical activity and an unbalanced diet. If the disease is identified upstream, at the prediabetes stage, its progression towards established diabetes can be counteracted by adopting an appropriate lifestyle.
Unfortunately, a third of patients already have cardiovascular, renal or neuronal complications at the time of diagnosis and thus see their life expectancy altered, the University of Geneva (UNIGE) said in a press release on Tuesday.
Identifying the shift from prediabetes to diabetes is complex, because the condition of the affected cells, scattered in very small quantities in the heart of an organ located under the liver, the pancreas, is impossible to assess quantitatively by non-invasive examinations.
“We therefore opted for an alternative strategy: find a molecule whose level in the blood would be linked to the functional mass of pancreatic beta cells in order to indirectly detect their alteration at the prediabetes stage”, explains Pierre Maechler, professor at the Faculty Center Diabetes from UNIGE, which directed this work.
An indicator molecule
The first step consisted in analyzing thousands of molecules in healthy, prediabetic and diabetic mice. By coupling powerful molecular biology methods with a machine learning (artificial intelligence) system, the team was able to identify the most promising one: it is 1,5-anhydroglucitol, a small molecule, the decrease of which in the blood would indicate a deficiency in beta cells.
Motivated by these results obtained in mice, the research team moved on to the next step: determining their relevance in humans. In collaboration with many scientists, including teams from the Geneva University Hospitals, they then compared the 1,5-anhydroglucitol level of diabetic patients with that of non-diabetic people.
“We were able to observe a decrease in this molecule in people with diabetes. It was very motivating, especially since this decrease was observable regardless of the symptoms, and even before the onset of diabetes”, says Cecilia Jiménez-Sánchez, postdoctoral fellow and first author of the study.
Potential tool for early diagnosis
“Diabetes is a complex disease in which many metabolic changes come into play in parallel. It was therefore essential to test the relevance of this marker in people who would experience a sudden loss of their beta cells but without a metabolic disorder”, explains Pierre Maechler.
“It is by studying the level of 1,5-anhydroglucitol in individuals whose half of the pancreas has been surgically removed that we have been able to truly demonstrate that 1,5-anhydroglucitol is a blood indicator of the functional quantity of beta cells of the pancreas”, adds the specialist.
This discovery opens up new avenues for the prevention of diabetes, particularly in people at risk. A simple blood test followed by an inexpensive specific test would thus make it possible to identify in them a potential diabetes in the process of development and to take measures before the situation is irreversible.
“We are still planning to test the relevance of this molecule in different types of patients and at different time scales, but it should allow great progress in the follow-up of people at risk”, concludes Pierre Maechler. This work is published in the Journal of Clinical Endocrinology & Metabolism.
