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Aims/hypothesis Metabolomics has opened new avenues for studying metabolic alterations in type 2 diabetes. While many urine and blood metabolites have been associated individually with diabetes, a complete systems view analysis of metabolic dysregulations across multiple biofluids and over varying timescales of glycaemic control is still lacking. Methods Here we report a broad metabolomics study in a clinical setting, covering 2,178 metabolite measures in saliva, blood plasma and urine from 188 individuals with diabetes and 181 controls of Arab and Asian descent. Using multivariate linear regression we identified metabolites associated with diabetes and markers of acute, short-term and long-term glycaemic control. Results Ninety-four metabolite associations with diabetes were identified at a Bonferroni level of significance (p

Context: In most ethnicities at least a quarter of all cases with diabetes is assumed to be undiagnosed. Screening for diabetes using saliva has been suggested as an effective approach to identify affected individuals. Objective: The objective of the study was to identify a noninvasive metabolic marker of type 2 diabetes in saliva. Design and Setting: In a case-control study of type 2 diabetes, we used a clinical metabolomics discovery study to screen for diabetes-relevant metabolic readouts in saliva, using blood and urine as a reference. With a combination of three metabolomics platforms based on nontargeted mass spectrometry, we examined 2178 metabolites in saliva, blood plasma, and urine samples from 188 subjects with type 2 diabetes and 181 controls of Arab and Asian ethnicities. Results: We found a strong association of type 2 diabetes with 1,5-anhydroglucitol (1,5-AG) in saliva (P = 3.6 x 10(-13)). Levels of 1,5-AG in saliva highly correlated with 1,5-AG levels in blood and inversely correlated with blood glucose and glycosylated hemoglobin levels. These findings were robust across three different non-Caucasian ethnicities (Arabs, South Asians, and Filipinos), irrespective of body mass index, age, and gender. Conclusions: Clinical studies have already established 1,5-AG in blood as a reliable marker of short-term glycemic control. Our study suggests that 1,5-AG in saliva can be used in national screening programs for undiagnosed diabetes, which are of particular interest for Middle Eastern countries with young populations and exceptionally high diabetes rates.

Background and Objectives: The prevalence of type 2 diabetes (T2D) in Qatar is the highest in the world. It is estimated that about one quarter of the T2D patients in Qatar are still undiagnosed. We set out to examine determinants of pre-diabetes (PD) or undiagnosed T2D (UT2D). Furthermore, we examined risk factors for glucose regulation in patients with known T2D. Methods: We examined 178 patients with known T2D and 196 controls. Anthropometrics and HbA1c were measured. Socio-demographic (age, gender, ethnicity and educational level) and health information were assessed through questionnaires. Results: Twenty-six (13.3%) and twelve (6.1%) participants in the control group were PD and UT2D, respectively. Control participants from South Asian descent were at a greater risk of being PD or UT2D than Arab controls (Odds Ratio: 5.27 (95% confidence interval: 2.10, 13.22). Being obese was also associated with an increased risk of PD or UT2D (Odds Ratio: 2.94 (95% confidence interval: 1.31, 6.59). Of control participants from South Asian descent, 38% were actually PD or UT2D. In patients with known T2D, insulin use and a longer duration of T2D were both related to higher HbA1c levels (both p