Early signs of type 2 diabetes can be identified more than 20 years before diagnosis, according to a new research presented at this year's European Association for the Study of Diabetes(EASD) Annual Meeting in Berlin, Germany (1-5 October). The research was published in Journal of the Endocrine Society.

The Japanese study tracked over 27,000 non-diabetic adults (average age 49 years) between 2005 and 2016 and found that increased fasting glucose, higher body mass index (BMI) and impaired insulin sensitivity were detectable up to 10 years before the diagnosis of diabetes as well as prediabetes.

Sagesaka and colleagues assessed the trajectories of fasting blood glucose, BMI, and insulin sensitivity in individuals who developed diabetes and prediabetes separately. At the start of the study, 27,392 non-diabetic individuals had a fasting glucose and average blood glucose (HbA1c) measured and were followed until a diagnosis of type 2 diabetes or prediabetes, or the end of 2016, whichever came first.

"As the vast majority of people with type 2 diabetes go through the stage of prediabetes, our findings suggest that elevated metabolic markers for diabetes are detectable more than 20 years before its diagnosis," says Dr Hiroyuki Sagesaka from Aizawa Hospital in Matsumoto, Japan.

In particular, BMI, fasting glucose, and insulin resistance were increased up to 10 years before diagnosis, and these differences widened over time. The research has important implications given that an estimated 425 million adults (aged 20-79 years) were living with diabetes in 2017, and this is predicted to rise to 629 million by 2045.

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