Identifying biomarkers of type 1 diabetes heterogeneity can help to stage the disease, and identify risks such as the early development of damage and complications.

Type 1 diabetes has long been considered to be an autoimmune disease in which failure of immune tolerance induces a specific immune attack on insulin-producing beta-cells. Recent research shows that the pathophysiology of type 1 diabetes is heterogeneous, involving various beta-cell-specific processes, different genetic predispositions, and several disease stages. It is very important to recognize this heterogeneity as it results in an accumulation of differences in outcomes during the course of the disease.

 

This heterogeneity requires further elucidation as a heterogeneous disease is likely to require multiple approaches to stop or cure the pathophysiological pathways. This underscores the need for more biomarkers to identify this heterogeneity, the different phases of disease and the effects of interventions and cures.

 

In many countries and research groups, data and samples from newly-diagnosed individuals (i.e. within the first 6 months after diagnosis) have been collected and studied. Fewer data and samples are available from people with type 1 diabetes with longer disease duration. This prompted JDRF to grant a strategic research agreement (SRA) to Diabeter and UMC Groningen. Both clinics have access to a substantial clinical database since 1998 with medical record data of > 3500 people with type 1 diabetes. 

 

In this BIOMARKER project, we intended to analyze hormonal, biochemical, immunological, inflammatory and psychological biomarkers of type 1 diabetes in people with a disease duration of > 5 years. Meanwhile, we keep searching for new markers. We have established a sample repository (serum, plasma, urine, DNA, RNA) which is also accessible to other interested collaborators.

The collection includes:

• Fasting samples (serum, plasma, urine, DNA, RNA) from 611 people with type 1 diabetes (> 5 years duration) taken annually at 3 timepoints (Biomarker cohort)
• Idem from 611 people with type 1 diabetes (> 35 years duration) taken cross-sectionally (Long-Term type 1 Diabetes or LTD cohort; also see below)
• From Biomarker cohort: samples from 169 people with type 1 diabetes who underwent Mixed Meal Tolerance Tests (MMTT with 5 timepoints) at 2 occasions (1-year interval)
• Data from questionnaires on psychosocial burden, quality of life, neuropathy and hypoglycaemia
• Clinical datasets on their health, diabetes history, family history and clinical course during treatment

 

 

SUCCESSFUL AGEING WITH TYPE 1 DIABETES : LTD cohort

An additional grant from the Diabetes Fonds enabled us to expand the BIOMARKER project with additional data and samples from 300 persons with longstanding type 1 diabetes, allowing a Dutch version of the ‘medalist cohort’. This is done in collaboration with several Dutch hospitals attending these people with diabetes.

 

The study has now finished. Click here for the publication on the setup and first results of the study.

 

Inquiries about these projects and applications for collaborative projects on these datasets/samples can be sent to the steering committee of BIOMARKER at research@diabeter.nl or to the investigators mentioned on this website.