Classical and new candidate biomarkers for developing biosensors in diagnosing diabetes and prediabetes; past, present and future

Diabetes mellitus (DM) is a devastating metabolic disease that leads to abnormal blood glucose levels. Due to serious health outcomes including cardiovascular, kidney, ophthalmologic, and neurologic diseases it is mandatory that DM is diagnosed, monitored, and controlled as soon as possible. Biosensors and point-of-care devices allow simple user-friendly monitoring of blood glucose levels. Several biomarkers are routinely used for monitoring the diabetic’s status such as glucose, glycated hemoglobin (HbA1C), and glycated albumin. The HbA1c has several advantages to the fating plasma glucose and oral glucose tolerance test, including greater convenience (fasting not required), greater preanalytical stability, and less daily perturbations during stress and disease. Traditional equipment use enzymatic methods to measure glucose concentration and provide information about spot samples. However, new continual glucose sensors are becoming a key part of the closed insulin delivery system, so it must be selective, fast, predictable, and acceptable for continual patient use. The combination of several new biomarkers such as miRNAs, proteomic, and metabolites can more accurately identify individuals at high risk of developing prediabetes and subsequent diabetes progression. Therefore developing biosensors for these biomarkers could enhance the detection accuracy of future diagnostic devices. This chapter describes the potential utility of biomarkers for developing biosensors that could be used against the burgeoning epidemic of dysglycemic disorders.