Diabetes: Looking Beyond Glucose to Understand Cardiometabolic Health

Every 14 November, World Diabetes Day reminds us of the importance of prevention, diagnosis, monitoring and research. It also invites us to broaden our perspective: metabolism cannot be explained by a single indicator.

Diabetes goes beyond blood glucose levels

Diabetes is characterized by impaired regulation of blood glucose, but its implications extend to multiple biological processes. In particular, insulin resistance and other metabolic disturbances may coexist with changes in lipid and lipoprotein profiles, as well as inflammatory processes that contribute to cardiovascular risk.

For this reason, alongside glycemic parameters, clinical assessment of people with diabetes considers other risk factors, including blood pressure, cholesterol and kidney function. No single biomarker can fully describe an individual's cardiometabolic status.

What can advanced metabolomics contribute?

Metabolomics examines groups of small molecules present in biological samples, making it possible to explore relationships between different metabolic pathways. In diabetes and cardiometabolic research, these technologies can help characterize patterns that may not be apparent when conventional parameters are assessed in isolation.

Advanced lipoprotein profiling, for example, enables researchers to investigate characteristics of the particles that transport lipids in the blood, including their size and concentration. Such data can enrich our understanding of metabolic heterogeneity and open new avenues for research.

It is important to distinguish research potential from clinical application: advanced metabolomic profiles do not replace diagnostic tests, clinical guidelines or assessment by healthcare professionals. Their usefulness for specific decisions must be supported by appropriate evidence and validation.

Liposcale®: A deeper look at lipoprotein profiles in diabetes

In type 2 diabetes, conventional LDL cholesterol does not always capture the full complexity of lipid abnormalities. Liposcale®, the advanced lipoprotein profiling technology developed by Biosfer Teslab, uses proton nuclear magnetic resonance (¹H-NMR) to characterize the concentration, size and composition of VLDL, LDL and HDL particles, including their large, medium and small subclasses.

This information supports research into patterns of atherogenic dyslipidemia, such as increased small LDL particles, changes in HDL and elevated triglycerides, which can be particularly relevant in the context of insulin resistance and type 2 diabetes.

The scientific value of this approach is supported by specific publications. In the methodological study by Mallol and colleagues (2015), Liposcale® helped distinguish lipoprotein profiles in people with type 2 diabetes with and without atherogenic dyslipidemia. More recently, the LIPOCAT study (2025), involving 933 participants with type 2 diabetes, found that adding advanced lipoprotein characteristics obtained using Liposcale® to models based on traditional risk factors improved discrimination of cardiovascular events in the models studied. The research also included glycoprotein profiling using Glycoscale.

What does this mean? Examining how lipoprotein particles are distributed and composed can provide complementary information for investigating differences in cardiometabolic risk. These findings do not mean that Liposcale® diagnoses diabetes, replaces conventional lipid testing, or that its routine use has independently been shown to improve clinical outcomes.

Research and precision medicine: Towards a more complete picture

People with diabetes do not necessarily share the same metabolic profile or identical risk factors. Combining clinical information with emerging analytical tools can help researchers investigate this diversity and develop more precise approaches in the future.

At Biosfer Teslab, we work in metabolomic analysis and advanced lipoprotein profiling using nuclear magnetic resonance technologies, generating insights for research into metabolic and cardiovascular health.

14 November: Awareness that drives knowledge

World Diabetes Day is an opportunity to highlight the importance of health education, healthy habits, access to healthcare and rigorous research. It is also a chance to foster collaboration among clinicians, researchers and biomedical technology companies.

Because progress in diabetes is not simply about measuring more: it is about understanding what each measurement means and the value it can offer in context.