Searching for new predictors of distant complications of diabetes - a systematic review

<ns3:p>Backgorund: Diabetes is one of the biggest public health problems of the current era. It develops numerous complications, which can be divided into macroangiopathies (ischemic heart disease, limb and cerebral vascular disease) and microangiopathies (retinopathy, nephropathy, neuropathy). They significantly limit patients' quality of life and survival. Therefore, it is extremely important to prevent and treat them early. For this reason, it is important to search for new biomarkers that will make this possible. The purpose of this paper is to search for such predictors using a systematic review method.Methods: A systematic review was conducted in online databases of full-text scientific papers from 2020-2025. 49 papers were included in the review.Results: Capillary blood glucose and HbA1c are adequate indicators of diabetes control, but have their limitations as predictors of distant complications in the disease. Among the best predictors are: fructosamine (nephropathy, macroangiopathy, postsurgica complications), interleukin 6 (microangiopathies), fetuin A (nephropathy, macroangiopathy), 1,5-anhydroglucitol (coronary heart disease), adiponectin (nephropathy, neuropathy), transferrin and ferritin (nephropathy, retinopathy), acylcarnitines (retinopathy, neuropathy), lipoprotein a and plasminogen activator inhibitor 1 (mainly macroangiopathies). Determination of their levels in blood or other biological materials can serve as a good predictor of the development of distant complications of diabetes, making it possible to identify patients at risk.Conclusions: There are good potential predictors (especially fructosamine) of distant diabetes complications other than glycemia and HbA1c. Their determination in the future may be incorporated into diagnostic protocols alone or in combination with older markers to identify at-risk patients and for effective prevention.</ns3:p>