IIT Bombay Discovers Biomarkers for Early Detection of Diabetic Kidney Disease: A Breakthrough in Personalized Treatment

A groundbreaking study led by IIT Bombay has successfully identified specific blood biomarkers that can serve as early indicators of diabetic kidney disease, revealing 26 distinct metabolites that differentiate diabetic patients from healthy individuals.

New Delhi researchers have made a significant advancement in diabetes management through this discovery, which could revolutionize early diagnosis and enable more personalized treatment approaches for patients.

India currently faces a diabetes epidemic, with approximately 101 million adults living with the condition and another 136 million at risk with prediabetes, earning it the unfortunate title of the world's diabetes capital. Type 2 diabetes has become a major public health challenge across the country.

Late diagnosis remains a critical issue, often leading to serious complications affecting multiple organs including eyes, kidneys, nerves, heart, and brain. Nearly one-third of diabetic patients ultimately develop chronic kidney disease, highlighting the importance of early detection.

The collaborative research team was led by Prof Pramod Wangikar from IIT Bombay, alongside Dr Rakesh Kumar Sahay and Dr Manisha Sahay from Osmania Medical College, with additional support from Clarity Bio Systems India in Pune. Their approach utilized metabolomics to analyze small molecules in blood samples, uncovering biochemical patterns that identify patients at risk for kidney complications.

This breakthrough will enable healthcare providers to diagnose kidney issues earlier and develop more tailored treatment protocols for diabetic patients.

"Type 2 diabetes extends far beyond elevated blood sugar levels. It disrupts multiple bodily pathways including amino acid metabolism and fat processing. Conventional testing methods frequently miss this hidden metabolic activity, which often begins years before clinical symptoms appear," explained Sneha Rana, a PhD scholar working in Prof Wangikar's laboratory.

The research involved collecting blood samples from 52 volunteers at Osmania General Hospital in Hyderabad between June 2021 and July 2022. Participants included 15 healthy control subjects, 23 patients with Type 2 diabetes, and 14 patients already diagnosed with diabetic kidney disease (DKD).

Researchers employed two complementary analytical techniques - liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) - to examine nearly 300 different metabolites in the samples.

Their analysis identified 26 metabolites that showed significant differences between diabetic patients and healthy controls.

Interestingly, the study revealed two distinct metabolic subgroups among diabetic patients. One group showed profiles relatively similar to healthy individuals, while the other exhibited significant changes related to stress responses, inflammation, and cellular energy production.

"These biomarkers could eventually become standard clinical tools, similar to how cholesterol tests are used to evaluate cardiovascular disease risk. This would allow physicians to identify which patients require more aggressive intervention and which might benefit primarily from lifestyle modifications," noted Dr Sahay.

When comparing patients with established kidney disease to other groups, the researchers identified seven specific metabolites that showed a progressive increase from healthy individuals to diabetic patients to those with DKD.

These key biomarkers included sugar alcohols such as arabitol and myo-inositol, as well as ribothymidine and a toxin-like compound called 2PY, which accumulates in the bloodstream when kidney function deteriorates.

"By monitoring these specific molecules, we could potentially predict kidney complications much earlier in the disease progression," Rana explained.

The research team plans to expand their study to include data from a larger population of subjects with diabetes and various complications. They also aim to develop simplified clinical tests that can facilitate early diabetes diagnosis and identify individuals at heightened risk for complications.

"In India, diabetes treatment often follows a standardized approach regardless of individual differences. These newly identified biomarkers will enable us to begin tailoring treatment plans to each patient's unique metabolic profile," Rana concluded.