Dysglycemia in prediabetes promotes endothelial dysfunction and inflammatory processes resulting in complications that precede the onset of full-blown diabetes. It is estimated that 25% of individuals with prediabetes will develop type 2 diabetes within 3–5 years, while 70% will experience it later in life. This investigation aims to identify proteins different throughout the progression from prediabetes to established diabetes state using a proteomic approach. 

Prediabetes (n = 6), early diabetes (n = 5) and established diabetes (n = 5) protein expression profiles were determined using two-dimensional gel electrophoresis. The 13 cm pH 3–10 isoelectric focusing strips and 12% acrylamide gel electrophoresis were applied for the first dimension to display the proteins. Coomassie staining and a Gel Doc TM XR+ Imager (BioRad) were utilised to visualise and image protein spots. Employing PDQuest (BioRad) software, images were compared and analysed. QTOF LCMS/MS was employed to determine the function of the identified proteins. The biological pathways that induce protein pattern alterations were observed using pathway analysis.

Five upregulated and three downregulated spot proteins were significantly identified between the groups. FXR/RXR activation, acute phase response signalling and LXR/RXR activation are the common canonical pathways of differentially expressed proteins found in the prediabetes group compared to early and established diabetes

The proteins that have been identified as expressed may play a role in the development of type 2 diabetes and its complications. Additional research focused on the prediabetes group is imperative to evaluate the issue's severity and provide future preventative and therapeutic interventions.