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Updated: Jun 26, 2025
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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
Published on: November 29, 2024
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Characterizing poorly controlled type 2 diabetes using 1H-NMR metabolomics
Isabella J Theron1, Shayne Mason1, Mari van Reenen1
1Human Metabolomics, Department of Biochemistry, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa.
Summary
Poorly controlled type 2 diabetes shows distinct urine metabolic changes affecting energy pathways and leading to organ damage. This study highlights the impact of diet and offers insights for improved treatment strategies.
Area of Science:
- Metabolomics
- Biochemistry
- Endocrinology
Background:
- Type 2 diabetes (T2D) prevalence is epidemic, with some patients experiencing poor glycemic control despite treatment.
- Limited understanding exists regarding metabolic derangements in poorly controlled T2D.
Purpose of the Study:
- To characterize the urine metabolome in a South African cohort with poorly controlled T2D.
- To identify specific urinary metabolites differentiating poorly controlled T2D from healthy individuals.
Main Methods:
- Untargeted proton nuclear magnetic resonance (1H NMR) metabolomics.
- Analysis of urine samples from 15 T2D patients and 25 healthy controls.
- Statistical comparison to identify differentiating metabolites.
Main Results:
- Poorly controlled T2D patients exhibited altered concentrations of metabolites linked to carbohydrate metabolism, ketogenesis, proteolysis, and the TCA cycle.
- Elevated metabolites indicated increased autophagy/apoptosis, uncontrolled dietary intake, and kidney/liver damage.
- Specific metabolic profiles were associated with impaired cellular glucose uptake and energy production.
Conclusions:
- Inhibited glucose uptake in poorly controlled T2D disrupts energy pathways, promoting apoptosis/autophagy and causing kidney/liver damage.
- Poor dietary compliance is implicated as a contributing factor to uncontrolled glycemic states.
- Findings provide a comprehensive overview of urine metabolic changes in poorly controlled T2D, suggesting avenues for targeted therapies and improved patient management.
