ongoing studies & trials


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 intend 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 are establishing a sample repository (serum, plasma, urine, DNA, RNA) which is also accessible to other interested collaborators.

The collection currently includes:

  • Fasting samples (serum, plasma, urine, DNA, RNA) from 600 people with type 1 diabetes (> 5 years duration) taken annually at 3 timepoints
  • Samples from 150 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




An additional grant from the Diabetes Fonds enables 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.



Additionally, this Diabetes Fonds grant allows initiation of a prospective cohort of newly-diagnosed children and youth. Objective is to collect data and samples for a sample repository to answer the question why and how the first year of type 1 diabetes has such a profound influence on the clinical course in the next 10-15 years. Is this the result of biological, psychological, psychosocial, educational or combined factors?


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

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