The prevalence of diabetes mellitus Type 2 could be significantly reduced by early identification of subjects at risk, allowing for better prevention and earlier treatment. Glucose intolerance (GI) is a hallmark of the prediabetic stage. This study aims at identifying 1) prognostic biomarkers predicting the risk of developing GI later in life and 2) diagnostic biomarkers reflecting the degree of already manifest GI. To this end, disease development was followed over time in mice, and biomarkers were identified using lipidomics and transcriptomics. Young adult ApoE3Leiden mice were treated a highfat diet for 12 wk to induce GI. Blood was collected before and during disease development. The individual extent of GI was determined with a glucose tolerance test and the area under the curve (AUC) was calculated for each animal. Subject-specific AUC values were correlated to the plasma lipidome (t ϭ 0) and the white blood cell (WBC) transcriptome (t ϭ 0, 6, and 12 wk) to identify prognostic and diagnostic biomarkers, respectively. The plasma ratio of specific free fatty acids prior to high-fat feeding (C16:1/C16:0, C18:1/C18:0 and C18:2/C22:6) was significantly correlated with the AUC and predictive for future GI. Subsequently, the expression level of specific WBC genes (Acss2, Arfgap1, Tfrc, Cox6b2, Barhl2, Abcb4, Cyp4b1, Sars2, Fgf16, and Tceal8) reflected the individual degree of GI during disease progression. Specific plasma free fatty acids as well as their ratio can be used to predict future GI. The expression levels of specific WBC genes can serve as easy accessible markers to diagnose and monitor already existing GI. plasma lipidomics; white blood cell transcriptomics; diabetes mellitus Type 2; diabetes mellitus Type 2-prone transgenic ApoE3Leiden mice DIABETES MELLITUS TYPE 2 (DM2) is a metabolic disorder whose incidence has rapidly increased over the past several decades (15, 28). DM2 accounts for 90 -95% of all diagnosed cases of diabetes and is associated with a high morbidity and mortality rate (1). Glucose intolerance is an indicator of the prediabetic state and a hallmark of the disease process leading to overt DM2 (28). Glucose intolerance is a condition in which an individual has higher than normal levels of glucose in the blood upon fasting or ingestion of a glucose test solution but not high enough to be classified as DM2. This can either be due to an insufficient production of insulin or due to an inefficient response of cells to insulin (insulin resistance). In both cases, the organ uptake of glucose from the blood stream is impaired resulting in a longer residence time and elevated levels of circulating glucose. Glucose intolerance is typically diagnosed with an invasive glucose tolerance test (GTT) in which glucose is given to a subject and blood samples are taken afterward to determine how quickly it is cleared from the blood. The test is time-consuming and elaborative, and new strategies to diagnose the degree of glucose intolerance are needed. This would allow routine monitoring of disease p...