Detecting diabetes before the first symptoms appear

Part of the beta cells of your pancreas (in the green) disappears when diabetes begins to develop (right image). This is in comparison to a healthy individual (leftimage). The blood level measured for 1,5-anhydroglucitol can reveal the cause of this previously undetectable decline. Credit: UNIGE – Laboratory of Prof. Pierre Maechler

In collaboration with the HUG, a team from the UNIGE discovered a molecule which can detect the development of diabetes before any symptoms appear.

Diabetes is a growing and severe metabolic disorder. It is already affecting hundreds of thousands in Switzerland. The disease is promoted by a sedentary lifestyle and excessively rich diet. It can be reversed if detected early enough. However, diagnostic tools that allow for early detection of the disease are not available. A team from the University of Geneva, in collaboration with several scientists, including those from the HUG, discovered that a low blood sugar 1,5-anhydroglucitol level is a sign of a decrease in functional beta cell function. This molecule can easily be identified by a blood test. It could be used to determine if someone is at risk for developing diabetes before it becomes irreversible. These results can be found at the Journal of Clinical Endocrinology & Metabolism.

Nearly 500,000 people in Switzerland have diabetes. Due to a combination of poor physical activity and a poorly balanced diet, this serious metabolic disorder is on the rise. An appropriate lifestyle can prevent the progression to diabetes if detected in the pre-diabetes stage. Unfortunately, a third of patients have already been diagnosed with neuronal, cardiovascular or renal complications, which can reduce their life expectancy.

It is difficult to determine the transition from prediabetes and diabetes because the condition of the affected cells is scattered in very small amounts in the core organ of the pancreas. Non-invasive investigations are not able to quantify this. We chose to look for a different strategy. To indirectly detect the alteration of beta cells at the pre-diabetes stage (before the appearance of symptoms), we looked for a molecule whose levels were associated with their functional mass in the blood.” Pierre Maechler is a Professor in Cell Physiology and Metabolism and in Diabetes Center of the UNIGE Faculty of Medicine.

A sugar that indicates beta cell status

Scientists set out to identify a molecule that could detect pre-diabetes several years ago. The first step was to analyze thousands molecule in pre-diabetic, diabetic and healthy mouse models. The research team combined powerful molecular biology techniques and an artificial intelligence machine to identify the one that best reflected a loss in beta cells at pre-diabetic stages. It was 1,5-anhydroglucitol. This small sugar is thought to indicate a deficit in beta cell function.

Pierre Maechler’s research team was inspired by the mice results and moved on to the next stage: determining its relevance for humans. They compared the levels 1.5-anhydroglucitol of diabetic patients and those of non-diabetics with the help of many scientists, including members of the HUG. “We were able observe a decrease of this sugar in diabetics. This was very motivating, especially as this decline was observable regardless their symptoms, even before the onset of diabetes”, indicates Cecilia Jiménez-Sánchez, postdoctoral fellow in the Department of Cell Physiology and Metabolism and first author of the study.

This could be a tool to help with early diagnosis

“Diabetes can be a complex disease, in which many metabolic changes take place simultaneously. Pierre Maechler says that this marker was essential in determining if it is relevant in people who suddenly lose their beta cells without metabolic disorders. “By studying the blood level of 1,5 -anhydroglucitol among individuals whose pancreas was removed in half, we were capable of proving that 1,5 -anhydroglucitol is a good indicator of functional pancreatic beta cells.”

This discovery opens up new avenues to prevent diabetes, especially for those at high risk. A simple blood sample followed by a specific test could detect a possible diabetes onset in these individuals. It is important to take action before the situation becomes irreversible. Pierre Maechler concludes that although we still plan to test the sugar in different patients and over different time periods, it could be a significant step in the monitoring of those at risk.

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More information:
Cecilia Jiménez-Sánchez et al, Circulating 1,5-Anhydroglucitol as a Biomarker of ß-cell Mass Independent of a Diabetes Phenotype in Human Subjects, The Journal of Clinical Endocrinology & Metabolism (2022). DOI: 10.1210/clinem/dgac444

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University of Geneva

Diabetes can be detected before symptoms appear (August 16, 2022).
Retrieved 16 Aug 2022
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