Amino acid metabolism may play a key role early in the development of type 2 diabetes. Wang et al reported that the risk of future diabetes was at least 4-fold higher in normoglycemic individuals with high fasting plasma concentrations of 3 amino acids (isoleucine, phenylalanine, and tyrosine). Concentrations of these amino acids were elevated up to 12 years prior to the onset of diabetes.  In this study, amino acids, amines, and other polar metabolites were profiled using liquid chromatography tandem mass spectrometry.
Overall, these studies suggest that tight glycemic control (HbA1c < 7% or lower) is valuable for microvascular and macrovascular disease risk reduction in patients with recent-onset disease, no known cardiovascular diseases, and a longer life expectancy. In patients with known cardiovascular disease, a longer duration of diabetes (15 or more years), and a shorter life expectancy, however, tighter glycemic control is not as beneficial, particularly with regard to cardiovascular disease risk. Episodes of severe hypoglycemia may be particularly harmful in older individuals with poorer glycemic control and existing cardiovascular disease.
Your primary care doctor can monitor you for diabetes at your regular checkups. Your doctor may perform blood tests to check for the disease, depending on your symptoms or risk factors. If you do have diabetes, your doctor may prescribe medication and manage your condition. They may also refer you to a specialist to help monitor your treatment. It’s likely that your primary care doctor will be part of a team of healthcare professionals who will work with you.
Genetics, lifestyle and environment can be causes of diabetes. Eating an unhealthy diet, being overweight or obese and not exercising enough may play a role in developing diabetes, particularly Type 2 diabetes. Type 1 diabetes is caused by an autoimmune response. The body’s immune system attacks and destroys the insulin producing beta cells in the pancreas.