MUMBAI – Researchers led by the Indian Institute of Technology Bombay have identified specific blood biomarkers that indicate early signs of diabetic kidney disease (DKD). This discovery holds potential for earlier diagnosis and more personalized treatment strategies for patients.
India faces a significant public health challenge with Type 2 diabetes . Approximately 101 million adults currently live with the condition. An additional 136 million are at risk due to prediabetes. Late diagnosis often results in severe health complications, including damage to eyes, nerves, heart, brain, and kidneys. Nearly one-third of individuals with Type 2 diabetes ultimately develop chronic kidney disease.
The research team comprised Prof. Pramod Wangikar from IIT Bombay, Dr. Rakesh Kumar Sahay and Dr. Manisha Sahay from Osmania Medical College, and experts from Clarity Bio Systems India, Pune. Their investigation employed metabolomics , a scientific method focused on studying small molecules within the blood. This approach aimed to uncover distinct biochemical patterns that could identify patients at heightened risk of kidney complications.
Study Methodology
The study involved collecting whole blood samples from 52 volunteers at Osmania General Hospital in Hyderabad. Sample collection occurred between June 2021 and July 2022. The volunteer group included 15 healthy individuals, 23 patients diagnosed with Type 2 diabetes, and 14 patients already suffering from diabetic kidney disease. Using two advanced techniques—liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS)—the researchers analyzed nearly 300 different metabolites .
Key Biomarker Discoveries
Analysis revealed 26 metabolites that showed significant differences between diabetic patients and healthy controls. Furthermore, the study identified two distinct metabolic subgroups among the diabetic patient population. One subgroup displayed metabolic profiles closely resembling healthy individuals. The other subgroup exhibited major metabolic alterations indicative of increased stress, inflammation, and disrupted energy production pathways within the body.
Sneha Rana, a PhD scholar working in Prof. Wangikar’s laboratory, emphasized that Type 2 diabetes extends beyond high blood sugar levels. It profoundly disrupts amino acid, fat, and other crucial metabolic pathways. Standard diagnostic tests frequently fail to detect this underlying metabolic activity. This hidden disruption can often begin years before the manifestation of clinical symptoms of organ damage.
Dr. Sahay highlighted the potential future application of these markers. He suggested they could be used by doctors similarly to how cholesterol tests assess heart disease risk. This capacity would allow for tailored treatment plans. Some patients might require more aggressive interventions, while others could benefit significantly from targeted lifestyle modifications.
Comparing patients with established DKD against other groups yielded a critical finding: seven specific metabolites showed a consistent, progressive increase. These levels rose steadily from healthy individuals, through diabetic patients, and peaked in those with DKD. The identified metabolites included sugar alcohols such as arabitol and myo-inositol. Also detected were ribothymidine and 2PY, a compound known to accumulate as kidney function declines and considered a toxin.
Rana stated that monitoring these particular molecules could enable prediction of kidney complications substantially earlier than current methods.
Future Research and Clinical Impact
The research team plans to expand this study. Future efforts will involve collecting data from a larger cohort of subjects, encompassing individuals with diabetes and various associated complications. The ultimate aim is to develop straightforward clinical tests. These tests would not only assist in the early diagnosis of diabetes itself but also precisely identify those individuals at a higher risk of developing severe complications like DKD.
Rana further explained that the new metabolic markers could revolutionize diabetes care in India. Instead of a generalized “one-size-fits-all” treatment approach, these markers would facilitate tailoring medical care to each patient’s unique biochemical profile and risk factors, leading to more effective outcomes.