Metabolomics Reveals Unexpected Responses to Oral Glucose

Abstract

In this issue of Diabetes , Ho et al. (1) present the largest metabolomic study to date of oral glucose challenges in humans at risk for type 2 diabetes mellitus (T2DM). Their observations of unexpected metabolic responses demonstrate the value of metabolomics as a tool for discovery in diabetes research. T2DM is widespread in developed countries, and its prevalence continues to grow. Associated morbidity and mortality are substantial, as is the economic burden imposed on society (2). Early interventions that modify diet, increase activity level, and reduce excess body weight, sometimes combined with drug therapy, are effective in preventing progression of prediabetes to T2DM (3,4). The risk of developing T2DM is currently evaluated using such traditional clinical parameters as family history and fasting plasma glucose. In the decade since the human genome was first sequenced, rapid development of the “omics” sciences and their enabling analytic technologies has fostered a search for genes, proteins, and metabolites that will strengthen existing models that predict T2DM risk (5). Diabetes is characterized by derangements in the processing of metabolic fuels. Metabolomics, in which one makes simultaneous measurements of many small metabolites, holds promise for uncovering early biomarkers of risk that can help to guide timely interventions and perhaps aid in the exploration of underlying biochemical mechanisms, as well (6). Recent longitudinal metabolomic studies have found …