'State-of-the-Art' metabolomics investigations of type 2 diabetes

Metabolomics represents the global investigation of complex biomolecular patterns in living systems, i.e. in organs, cells, tissues or biofluids, and the understanding of how clinically significant deviations from such patterns may facilitate our knowledge of the pathogenesis of human diseases. This now widely expanded research area has been extensively applied to the prognostic monitoring of type 2 diabetes (T2D), particularly in human biofluids. The achievements of T2D metabolomics investigations include the identification of key biomarkers in human biofluid samples, which may also be employed for determining individuals at risk of this condition. T2D biomarkers arise from disturbed metabolic pathways, which include those distinct from glycolysis and lipid metabolism. Additionally, prognostic fingerprints and biomarkers of insulin resistance have been explored using metabolomics analysis, and these strategies have been critically evaluated for their possible future 'point-of-care' uses in clinical settings. The potential advancement for such 'bedside' metabolomics tests and the future direction of metabolomics in T2D is discussed in detail.