Simon Elias¹, Mohr Lea², White Alexander³, Fuchs Lina⁴, Bell Noah⁵, Schwarz Emma⁶, Graham Felix⁷
ABSTRACT:
Type 2 diabetes mellitus (T2DM) is characterized by progressive insulin resistance and declining β-cell function, yet current diagnostic criteria rely primarily on glucose measurements that detect disease only at advanced stages. This review evaluates established and emerging biomarkers that quantify these fundamental pathophysiological processes. We discuss dynamic measures (HOMA-IR, Matsuda index), circulating proteins (adiponectin, fetuin-A), inflammatory markers (IL-6, hs-CRP), and novel approaches (proinsulin/C-peptide ratio, β-cell-derived miRNAs). Their utility in early risk prediction, subphenotyping, and monitoring therapeutic responses is examined alongside technological advances in multi-omics profiling. Challenges in standardization and clinical validation are addressed, with emphasis on integrating biomarkers into precision medicine approaches for diabetes prevention and management.