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From data-driven care to disease-modifying biology

Diabeter NL & Diabeter Centre Amsterdam/Amsterdam UMC research highlights (2025)

In 2025, researchers affiliated with Diabeter Netherlands and Diabeter Centre Amsterdam / Amsterdam UMC published work spanning the full bench-to-bedside-to-workflow  spectrum: from care models that make diabetes device data actionable at scale, to biological strategies aimed at modifying disease processes, and to psychosocial and family-focused research supporting people living with type 1 diabetes (T1D). Fourteen publications cluster around three connected research themes.
 

1) Smarter care pathways powered by real-world device data

  • CGM and automated insulin delivery generate increasingly dense data streams. How can teams identify who needs support now without increasing clinician burden? A clear example is CloudCare, a clinician-developed population health management system that continuously monitors device metrics across a clinic population and supports proactive triage. In a prospective cohort evaluation, CloudCare use was associated with higher treatment satisfaction, fewer face-to-face contacts, and maintained excellent glycaemic outcomes over six months, supported by shared dashboards and a dedicated monitoring team (Van Beers et al.)
     
  • In routine care it was observed that technology-enabled care may also have effects on weight. A real-world study of the MiniMed 780G advanced hybrid closed-loop system showed that weight gain after initiation is common but not universal. By distinguishing people who gained weight from those who did not, the study identifies subgroups at higher risk and underscores the need for targeted lifestyle counselling alongside closed-loop initiation.(De Koning/Dekker et al.)
     
  • A study on sex-based differences in perceived versus objectively measured glycaemic control shows that subjective experiences do not always align with device-derived metrics, reinforcing the importance of interpreting technology data within a psychosocial context. (Fuhri Snethlage et al.)
     
  • The international SKIN-PEDIC study shows that skin complications related to diabetes devices are common in children and adolescents, with implications for comfort, adherence, and long-term technology use. (Berg et al.)

  • User perspectives add essential context. A qualitative study of adults using a bihormonal fully closed-loop system found that while glycaemic control and quality of life often improve, sustained use depends on whether users can reconcile technological demands with perceived benefits, highlighting that fully closed-loop systems are not simply “plug-and-play”. (Nefs et al.)

2) Toward disease-modifying strategies: microbiome, metabolites, and immune modulation

A second research line focuses on biological mechanisms that could ultimately shift T1D management from lifelong insulin replacement toward preservation and prevention.

  • A narrative review integrates evidence from microbiome research, metabolomics, and immunomodulation, outlining how these interconnected systems may be targeted in next-generation therapies and arguing for biomarker-guided, combination approaches. (De Groen et al.)
     
  • Within this framework, a pilot intervention study evaluated daily autologous lyophilized fecal microbiota capsules in adults with T1D. The intervention was safe and well tolerated, and C-peptide decline observed during run-in appeared to stabilise during treatment, supporting feasibility and the rationale for larger controlled trials. (De Groen et al.)
     
  • Complementary work explores whether gut microbial metabolism of methylglyoxal—a reactive dicarbonyl implicated in oxidative stress and diabetic complications—may influence host physiology, positioning microbial methylglyoxal handling as a potential therapeutic target. (Akinrimisi et al.)
     
  • Biomarker-focused studies further support the concept of modifiable disease processes. A large cohort study shows that plasma proinsulin often remains detectable long after T1D diagnosis, even in the absence of C-peptide, suggesting persistence of stressed but viable beta cells. (De Wit et al.)
     
  • In addition, a targeted proteomics study identifies biological signals associated with impaired awareness of hypoglycaemia, including lower agouti-related protein levels, offering new hypotheses for this high-risk complication. (Varkevisser et al.)
     

3) Psychosocial health and family systems as core components of T1D outcomes

Several 2025 publications emphasise that glycaemic outcomes and quality of life are shaped by psychological, social, and family contexts, and that these must be addressed with the same level of precision as biomedical factors.

  • At the conceptual level, a PSAD Study Group commentary argues that the clinical translation of precision diabetes medicine requires precision mental health care, calling for routine assessment of diabetes distress and integration of mental health outcomes into personalised care pathways. (Pouwer et al.)
     
  • Family-centred research features prominently. A large systematic review of parenting interventions for parents of children with T1D reports mixed overall effects but finds that intensive, targeted interventions show the most promise, highlighting the need to tailor support to family needs.(Jansen et al.)
     
  • A complementary conceptual paper addresses the transfer of diabetes care responsibilities from parents to children, outlining principles to support healthy transitions during childhood and adolescence. (Aalders et al.)