Breakthrough test could predict deadly diseases in diabetics

A blood test may be able to predict diabetic people’s risk of heart and kidney disease, according to a new study. Researchers have found high levels of four biomarkers, which are biological signposts, are strongly predictive for the development of heart and kidney issues for people with type 2 diabetes. A study has found that people who took a drug called canagliflozin had lower levels of the four biomarkers compared to those who took a placebo. The treatment helped to substantially reduce the risk of being admitted to hospital for heart failure and other heart complications among patients considered to have the highest risk. Lead author James Januzzi, the Hutter Family Professor of Medicine at Harvard Medical School, US, said: ‘High levels of certain biomarkers are indicators of heart and kidney complications, and may help predict future risk of disease progression. ‘Treatment with canagliflozin, a sodium glucose co-transporter 2 inhibitor, lowered biomarker levels and reduced the risk of hospitalisation for heart failure and other heart complications in people at the highest risk.’ Doctors regularly used a blood test to measure biomarkers to screen, diagnose or treat specific conditions. Previous research has shown concentrations of some biomarkers may predict the onset and progression of chronic kidney disease as well as heart disease in people with type 2 diabetes. The researchers analysed blood samples of 2,627 people who took part in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (Credence) trial in the US. They looked at the effects of canagliflozin on concentrations of the four biomarkers from the study start, then at the one-year mark and the three-year mark. The researchers examined how effective each biomarker was at indicating various levels of kidney problems and risk of death due to kidney disease or cardiovascular disease. Patients were separated into low, medium and high-risk categories. Those at the highest risk showed dramatically higher rates of progressive kidney failure and cardiovascular complications throughout the three-year study period. According to the findings published in the Circulation journal, high concentrations of each biomarker at the beginning of the study were strongly predictive of the severity of the patient’s heart and kidney issues. Concentrations of each of the four biomarkers in people taking canagliflozin were lower after one year and three years compared to those taking the placebo. After one year, the levels of all biomarkers in people who took canagliflozin rose 3% to 10%, compared to an increase of 6% to 29% in those who were not given the medication. Dr Januzzi, a cardiologist at the Massachusetts General Hospital and director of heart failure and biomarker trials at the Baim Institute for Clinical Research in Boston, said: ‘It was reassuring to discover that canagliflozin helped reduce risks the most in people with the highest chances for complications. ‘Future studies are needed to better understand how type 2 diabetes in conjunction with kidney disease develops and progresses so that we may initiate life-saving therapies earlier, before symptoms of heart and kidney disease have occurred. ‘Given that the American Heart Association/American College of Cardiology and the American Diabetes Association now all recommend measurement of biomarkers to enhance ability to predict risk in persons with type 2 diabetes, these results may considerably extend the reach of biomarker-based testing, refining accuracy even further.’