Innovative Blood Tests Help Doctors Personalize Diabetes Treatment

Researchers are discovering new blood markers to help personalize treatments for diabetic patients, potentially making standardized treatment a thing of the past. Using innovative blood tests, biomedical scientists and healthcare practitioners can tailor medical and surgical interventions to each patient's individual needs.

Everyone’s body is unique, but modern medicine standardizes treatments largely based on medical conditions rather than a person’s unique physiology. Fortunately, however, healthcare is slowly advancing to personalize treatments to a patient’s distinct needs with new technology like innovative blood and DNA tests.

Growing medical research shows that an individual’s metabolism and chemistry operate uniquely. Using improved diagnostic tools, healthcare providers can more quickly and confidently personalize treatment. This saves providers time and energy and leads to quicker patient improvement.

To improve current diagnostics, scientists are developing targeted blood tests that look for chemical byproducts of metabolism, called metabolites, associated with various diseases and personal metabolism. Growing research on metabolites has prompted a new science called metabolomics, which is the study of the metabolites found in an organism, like humans, viruses, and bacteria. The unique set of an organism’s metabolites is called its metabolome.

By testing a patient’s metabolome, experts and innovators hope metabolomics will improve diagnostic tools and treatments for chronic illnesses like diabetes.

What are metabolites?

Metabolites are small molecules created by the body’s metabolism. Through metabolism, nutrients, and chemicals are broken down and altered for use in each of the body’s systems and cells. As a result, new molecules are constantly created in every living organism through common chemical reactions. These tiny molecular byproducts are metabolites.

These metabolites have various functions. They provide the body with energy, structure, messages, defense, and transformation, to name a few of their roles.

Biomedical researchers and healthcare providers use metabolites to help monitor health and disease, assess disease severity, test drug development, predict and monitor disease progression, recommend particular treatments, and clarify disease mechanisms.

As personalized medicine grows in sophistication, scientists are discovering new and better metabolic biomarkers to use as diagnostic and treatment prediction tools.

Metabolites may help doctors personalize weight-loss treatment

Surprisingly, scientists have discovered that gut-related metabolites may help predict which treatments are best suited for individual patients facing severe obesity and diabetes. The success of weight-loss treatments varies greatly among diabetic patients, making it difficult for doctors to predict successful outcomes from various treatments. Metabolites may help target interventions for these patients.

Gut-related metabolites are produced by the healthy bacteria living along the digestive tract, mostly in your large intestine. As these bacteria help digest and transform nutrients, they produce molecules known as gut-related metabolites.

A study published in Nutrition and Diabetes in 2021 sought to identify metabolites that may predict whether patients with severe obesity will experience the longest-lasting weight loss and remission from type 2 diabetes from either surgery or lifestyle changes.

The study’s authors wrote, “Identifying individuals who would benefit the most from a given weight loss strategy (which surgery vs. lifestyle changes) would allow for a more personalized approach to weight loss intervention.”

After testing 135 different biomarkers using blood drawn from 2,458 surgical patients and 5,145 lifestyle change patients, the study found two metabolites that appear to predict whether a patient will experience more sustained weight loss and type 2 diabetes remission from surgery or lifestyle changes.

One metabolite, called factor 2, was composed mostly of amino acids. The second was factor 14, composed mostly of gut-related metabolites composed of betaine and choline.

Using these two metabolites, doctors may be able to determine if surgery or lifestyle changes would be the best option for each patient based on a simple blood draw for these biomarkers. As a result, healthcare providers hope to see improved patient outcomes compared to current outcomes from standardized treatments.

In general, lifestyle changes aren’t as effective as many physicians hope for most patients, largely because patients struggle to learn and adhere to the changes. A 2012 study published in the Journal of the American Medical Association (JAMA) found that intensive lifestyle intervention (ILI) only improved the weight loss and blood sugar levels of about 10% of patients at the end of the first and 48^th year.

Bariatric surgery is typically the treatment of choice for people with severe obesity because it offers the greatest and longest-lasting weight loss. The procedure also reduces related risks like cardiovascular disease for many patients. Still, the results are highly variable for different individuals and types of bariatric surgeries.

Personalized and precisely targeted treatments based on improved blood draws may allow patients to lose weight quicker, regain their health, diminish multiple complications, and reduce the risk of failed treatments.

Other metabolic biomarker studies for diabetic patients

While many of these types of studies need further work and refinement before healthcare facilities can apply them to patients, the results are promising for personalizing treatment in many ways for diabetic patients. Other studies demonstrate such promise.

A 2022 study published in the journal BMC Medicine found metabolites linked to predicting whether patients with combined heart disease and diabetes recover better from dietary changes or medications. Since the mixture of heart disease and diabetes is dangerous, discerning which treatments are best for individual patients will improve their health quicker, significantly reducing health risks.

Another 2022 study published in the Journal of the American Heart Association found that certain biomarkers may predict which patients are at greater risk of acute kidney injury (AKI) caused by the contrast used during coronary angiography, a common imaging study for diabetic patients with heart conditions.

Contrast-associated acute kidney injury (CA-AKI) is a dangerous risk for diabetic patients as it can result in permanent kidney damage or, at the very least, a lengthy and risky hospital stay.

Knowing which patients are at a higher risk of CA-AKI helps healthcare providers proceed more cautiously with such patients, saving them from increased suffering and cost.

These are just two of the countless studies on using metabolites to diagnose and treat patients. Researchers are discovering wide-ranging uses for metabolites for everyone — not just diabetic patients — from discerning wine preferences based on salivary proteins to metabolites associated with death, longevity, and COVID-19 susceptibility.

As with all research, more studies are needed to refine the use of metabolites in medicine. Still, the future of innovative diagnostics is very promising.