Identifying individuals at risk of type 2 diabetes requires insights into early pathophysiological changes. Findings were presented at EASD 2025. 

The study analyzed 694 participants from the Swedish CardioPulmonary bioImage Study, comparing 347 participants who developed dysglycemia over a median follow-up of 18.2 years with 347 matched controls. Using targeted proteomics, ten plasma proteins—including fatty acid binding protein 4, fibroblast growth factor 21, galectins, interleukin-1 receptor antagonist protein, LDL receptor, P-selectin glycoprotein ligand 1, retinoic acid receptor responder protein 2, and tissue-type plasminogen activator—predicted incident dysglycemia. Conversely, lower IGFBP-2 and PON3 levels increased risk. Several proteins were linked to future insulin resistance and beta cell dysfunction, with RARRES2 notably associated with reduced beta cell function. 

These results highlight molecular pathways driving dysglycemia and emphasize the potential of plasma protein profiling for early identification of high-risk individuals, guiding preventive strategies and novel therapeutic approaches.