Metabolomics in type 2 diabetes: From pathogenesis to biomarkers, precision treatment, and complication management.

Type 2 diabetes mellitus (T2DM), a chronic hyperglycemic disorder, adversely affects multiple organs, including the kidneys, retina, and cardiovascular system. Despite significant advancements, the understanding of early screening, diagnosis, prognosis, biomarkers, and the molecular pathways involved in T2DM and its complications remains limited. Metabolomics has emerged as a powerful tool for exploring complex metabolic networks, allowing rapid investigation of disease-specific metabolic processes and offering deeper insights into pathophysiological mechanisms. This review evaluates the application of metabolomics in T2DM research, with a particular emphasis on its role in risk prediction and elucidating disease mechanisms. By summarising current literature, the review highlights metabolomics' contributions to the discovery of T2DM biomarkers, the understanding of metabolic mechanisms, and the study of T2DM complications. Additionally, it examines its potential in personalised diagnosis, prognosis, and treatment. Metabolomics plays a pivotal role in T2DM research, as the analysis of metabolites in biological fluids facilitates the identification of biomarkers for early diagnosis and risk prediction, provides insights into disease mechanisms, supports precision medicine, and enables early detection of diabetic complications. However, challenges remain, and future efforts should focus on multi-omics cohort studies to advance its clinical applications.