Metabolomic associations of impaired awareness of hypoglycaemia in type 1 diabetes

R D M Varkevisser*, A Cecil, Cornelia Prehn, D Mul, H J Aanstoot, A D Paterson, B H R Wolffenbuttel, M M van der Klauw

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Downloads (Pure)


This study investigates impaired awareness of hypoglycaemia (IAH), a complication of insulin therapy affecting 20-40% of individuals with type 1 diabetes. The exact pathophysiology is unclear, therefore we sought to identify metabolic signatures in IAH to elucidate potential pathophysiological pathways. Plasma samples from 578 individuals of the Dutch type 1 diabetes biomarker cohort, 67 with IAH and 108 without IAH (NAH) were analysed using the targeted metabolomics Biocrates AbsoluteIDQ p180 assay. Eleven metabolites were significantly associated with IAH. Genome-wide association studies of these 11 metabolites identified significant single nucleotide polymorphisms (SNPs) in C22:1-OH and phosphatidylcholine diacyl C36:6. After adjusting for the SNPs, 11 sphingomyelins and phosphatidylcholines were significantly higher in the IAH group in comparison to NAH. These metabolites are important components of the cell membrane and have been implicated to play a role in cell signalling in diabetes. These findings demonstrate the potential role of phosphatidylcholine and sphingomyelins in IAH.

Original languageEnglish
Article number4485
Number of pages9
JournalScientific Reports
Publication statusPublished - 23-Feb-2024


  • Humans
  • Diabetes Mellitus, Type 1/genetics
  • Sphingomyelins
  • Genome-Wide Association Study
  • Hypoglycemia/genetics
  • Phosphatidylcholines
  • Awareness/physiology

Cite this