A Retrospective Analysis of the Association Between Prediabetes and Biomarkers of Intestinal Permeability in Patients with Prediabetes from Durban, South Africa

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by insufficient insulin production and diminished insulin receptor sensitivity. Prediabetes, which often precedes T2DM, involves elevated blood glucose levels that do not yet meet T2DM diagnostic criteria. Research has shown that complications linked to T2DM often begin during this prediabetic phase. In this study, we examined changes in intestinal barrier integrity during prediabetes by measuring biomarkers associated with intestinal permeability. With ethical approval, samples were collected from King Edward Hospital and Albert Luthuli Central Hospital in Durban and categorized into type 2 diabetes (T2D), prediabetes (PD), and non-prediabetes (NPD) groups. Blood levels of neutrophils and HbA1c were measured and analyzed, followed by serum zonulin and plasma levels of markers, including IFABP, sCD14, TNF-α, IL-6, glucose, insulin, and pancreatic lipase, which were measured and analyzed. The results showed significantly higher levels of these markers in the PD group compared to the NPD group, with further elevations in the T2D group. These findings align with existing research suggesting an association between increased intestinal permeability and the development of prediabetes. Altogether, these results indicate that prediabetes is a transitional phase marked by metabolic and intestinal permeability changes, though less severe than in T2DM. This underscores the need for additional research to cover a wider range of metabolic health, oxidative stress, inflammation, and vascular function markers, as such comprehensive assessments could provide deeper insight into underlying physiological processes.