Figure 1. Metabolomics as a snapshot of diabetes pathophysiology.

Diabetes is the culmination of metabolic insults that originate from a combination of genetic and environmental factors. These factors cause metabolic dysfunction, inflammation, and autoimmunity (in the case of type 1 diabetes), and eventually lead to overt hyperglycemia and diabetes, of which the potential microvascular and macrovascular complications are well-described. At each stage of this process, distinct molecular signatures can be identified in the blood through metabolomic profiling. Shown here is an overview of select metabolite pathways that have been linked with the risk of incident diabetes in human epidemiologic studies. Higher levels of metabolites in red are associated with higher diabetes risk and metabolites in blue are inversely related to diabetes risk. Each metabolite displayed here is also involved in numerous other biological pathways that are not shown in this figure for the sake of simplicity.