Update Publications Co-authored by Diabeter Centrum Amsterdam and Amsterdam UMC researchers
Diabeter's research programme has grown significantly with the joining of researchers from Amsterdam UMC, who have been studying type 1 diabetes (T1D) for many years. Their expertise strengthens our mission to improve care and outcomes for people living with T1D throughout their lives. All people with T1D have transferred their care to Diabeter Centrum Amsterdam (DCA), and several Amsterdam UMC clinician-researchers now work part-time at DCA — bringing with them a rich body of ongoing and recently published research. Below is an overview of their publications from 2025 up to now, organised by theme. Together, these papers reflect the full breadth of T1D research at our centre: from disease origins and early detection, to diabetes technology, complications, and quality of life.
1. T1D and the Gut Microbiome
Early-Life Gut Microbiota & The Immune System in T1D: The first years of life are a critical window for immune development, and the gut microbiome plays a central role. This review summarises how disruptions in early colonisation — from caesarean delivery, antibiotics, or formula feeding — impair immune tolerance and raise the risk of autoimmune diseases including T1D. The authors discuss interventions such as probiotics and faecal microbiota transfer as potential ways to restore this balance.
Advances in Gut Microbiome Research in T1D: A complementary in-depth review covering the role of gut microbial metabolites — including short-chain fatty acids, tryptophan metabolites, and bile acids — in T1D pathogenesis. The paper presents compelling evidence that characteristic microbiome alterations precede clinical T1D onset, and that targeted microbiome interventions including faecal microbiota transplantation can preserve beta-cell function in newly diagnosed patients. The authors call for a personalised medicine approach to translate these findings into clinical practice.
2. Early Detection and Prevention
Early Detection of T1D: A Roadmap for European Implementation: Across Europe, between 20 and 67% of children are still hospitalised with diabetic ketoacidosis at T1D diagnosis. This international consensus paper makes the case for population-wide islet autoantibody screening and presents a practical roadmap for implementation. The paper highlights that disease-modifying therapy (teplizumab) is now available to delay progression in those identified at stage 2 T1D, and that the scientific justification for general population screening is compelling.
3. Technology in Diabetes Management among women with T1D
AID Use and Challenges in Glycaemic Control Among Women with T1D: Women with T1D face unique challenges throughout their lives — from puberty and menstrual cycles to pregnancy and menopause — yet remain underrepresented in clinical research. This narrative review examines sex-related disparities in T1D management and how the MiniMed™ 780G system addresses them. Real-world data from over 280,000 users confirm comparable glycaemic outcomes between women and men, including during menstrual cycle phases where hormonal fluctuations typically impair control.
Personalized AID Use in Pregnant Women with T1D: Not all pregnant women benefit equally from AID therapy. This secondary analysis of the CRISTAL trial identifies which subgroups gain the most: women with well-controlled diabetes at the start of pregnancy, those new to AID, and women without higher education showed the greatest improvements in time in range. The findings support early initiation of AID in pregnancy and highlight the need for pregnancy-specific algorithms.
Cost-effectiveness of AID Use in Pregnant Women with T1D: Higher device costs are often cited as a barrier to AID adoption. This economic analysis of the CRISTAL trial data shows that the MiniMed™ 780G is in fact cost-saving during pregnancy compared to standard care, primarily because it reduces hospitalisation. On average, women using AHCL spent 3 days in hospital compared to 11.5 days in the standard care group — more than offsetting the device cost.
4. Cardiovascular and Kidney Complications
Coronary Plaque Burden in T1D: Using AI-enhanced coronary CT angiography, this study compared plaque burden in 58 well-managed middle-aged people with T1D against healthy controls. Encouragingly, the groups showed comparable levels of coronary plaque — a striking contrast to older studies. LDL cholesterol emerged as the most important modifiable risk factor, with every 0.5 mmol/L increase associated with a 34% relative increase in atheroma volume. The authors see cautious optimism in the data, suggesting that modern T1D management may genuinely be reducing cardiovascular risk.
T1D Increases the Risk of Dementia: This nationwide Swedish register study of over 43,000 individuals with T1D shows they face twice the risk of dementia compared to matched controls, with diagnosis occurring nearly five years earlier. The excess risk was highest for vascular dementia. Higher HbA1c and blood pressure were among the key modifiable risk factors identified, pointing to opportunities for prevention through improved glycaemic and vascular control.
Need for Renoprotective Therapies for Chronic Kidney Disease in T1D: Despite the revolution in kidney-protective therapies (SGLT2 inhibitors, GLP-1 receptor agonists) that has transformed outcomes in type 2 diabetes, T1D has largely been left behind. This review argues that kidney disease is a forgotten legacy of T1D and calls for adequately powered clinical trials in this population. The safety barrier of diabetic ketoacidosis risk with SGLT2 inhibitors remains the key obstacle to be overcome.
Insulin Resistance in T1D with Diabetic Kidney Disease: Using the gold-standard euglycemic clamp technique, this pilot study provides the first direct evidence that people with T1D and kidney disease have substantially lower insulin sensitivity than those without kidney disease — with measured insulin sensitivity 62.5% lower in the kidney disease group. The study also evaluates how well existing estimation formulas perform in this population and calls for larger confirmatory studies.
Physiology and Clinical Implications of SGLT-2 Inhibitors in Diabetes: This mechanistic review clarifies how SGLT2 inhibitors protect the kidney by reducing pressure within the glomerulus, and why this effect differs between people with type 1 and type 2 diabetes. Importantly, the review confirms that the initial dip in kidney filtration rate seen with these drugs is not harmful — and is in fact associated with better long-term kidney function preservation.
5. Mental Health, Wellbeing, and Women's Health
Diabetes and Mental Health: A Comprehensive Review: Published in The Lancet Diabetes & Endocrinology, this landmark review covers five major mental health problems in diabetes: fear of hypoglycaemia, diabetes distress, depression, disordered eating, and sleep disorders. The authors document high prevalence, serious clinical consequences, and the consistent failure of clinical practice to identify and address these problems. The concluding message is clear: diabetes care must include precision mental health care.
Fatigue, Diabetes Distress and Emotional Well-Being in T1D: In a sample of 319 adults with T1D, over half experienced severe fatigue, nearly three quarters elevated diabetes distress, and almost six in ten had low emotional well-being. Network analysis revealed that while these problems frequently co-occur, they function largely independently at the symptom level — suggesting that each requires its own targeted approach rather than assuming that treating one will resolve the others.
Screening for Eating Disorders in Women with T1D: Women with T1D have an elevated risk of disordered eating, including insulin omission for weight control — a dangerous behaviour. This study validates the Diabetes Eating Problem Survey-Revised (DEPS-R) screening tool against formal diagnostic interviews in 293 women across Norway, the Netherlands, and the United States. The tool showed good overall accuracy (AUC 0.82) and the authors provide practical guidance on which specific items best identify those most at risk in clinical settings.
Menopause in T1D and Perceived Glucose Regulation: Two thirds of postmenopausal women with T1D report moderate to severe changes in their glucose regulation after the menopause transition, according to this survey study. Changes were most pronounced in the first five years after the final menstrual period and included both more hyperglycaemia and more hypoglycaemia — reflecting increased variability rather than a uniform shift. The study calls for greater awareness among clinicians treating women with T1D through the menopausal transition.
