Why women with type 1 diabetes often develop polycystic ovary syndrome

Trial details

Who runs it

Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal

Trial code

NCT07490964

Record updated

3 September 2026

Original description

BACKGROUND Functional ovarian hyperandrogenism, including the polycystic ovary syndrome (PCOS), is very prevalent in women with type 1 diabetes (T1D). The pathogenic mechanisms of this association remain unclear.Read full original descriptionShow less

Pathogenesis of Functional Hyperandrogenism in Women With Type 1 Diabetes Mellitus: From Genetic-molecular Mechanisms to Clinical Phenotype.

BACKGROUND Functional ovarian hyperandrogenism, including the polycystic ovary syndrome (PCOS), is very prevalent in women with type 1 diabetes (T1D). The pathogenic mechanisms of this association remain unclear.

HYPOTHESIS Individual factors expose or protect women with T1D to/from the development of androgen excess and PCOS. Such androgen excess in women with T1D may increase their cardiometabolic risk.

MAIN OBJECTIVE Unveiling the pathogenic mechanisms behind functional hyperandrogenism in women with T1D from a sex/gender-medicine and sexual dimorphism perspective.

MATERIAL AND METHOS We have designed a cross-sectional comparative clinical study, including 5 groups of study subjects with 12 participans per group:

i) Women with T1D \& PCOS. ii) Women with T1D without PCOS. iii) Men with T1D and normal gonadal function. iv) Women with PCOS without diabetes mellitus v) Non-hyperandrogenic control women without T1D. All groups will show similar age and body mass index. T1D groups will be matched for duration of disease.

OUTCOMES 1.1 Insulin sensitivity (hyperinsulinaemic euglycaemic clamping). 1.2 Body composition (dual-energy x-ray absorptiometry, bioelectrical impedance analysis \& sonographic studies).

1.3 Ovarian and adrenal steroidogenesis. 2.1 Differential pattern in genetic variants related with insulin signalling and response, inflammation, adiposity, gonadal function, steroidogenesis, and PCOS itself by whole exome sequencing.

2.2 Microbiopsy studies in deep subcutaneous adipose tissue and skeletal muscle tissue: 2.2.1 Differential DNA methylation patterns in genes associated with PCOS. 2.2.2 Differential transcriptomic pattern in genes associated with PCOS.

2.2.3 Differential proteomic patterns in adipose and muscle tissues. 3. Interaction between T1D and PCOS on parameters of metabolic control (intersticial blood glucose monitoring) and morbidities associated with T1D itself.

Inclusion: Age between 18 and 45 years old; Diagnosis of type 1a diabetes at least 12 months before inclusion in the study, confirmed by positive autoimmunity and complete insulin deficiency; Treatment with subcutaneous insulin therapy (multiple doses or continuous infusion); Availability of metabolic control data (continuous interstitial blood glucose monitoring) at least in the month prior to study entry.

Exclusion: Diagnosis of other serious chronic disease. reatment with oral contraceptives or glucocorticoid therapy in the 3 months prior to inclusion in the study; Menarche at least three years prior to study entry; Previously known carbohydrate metabolism abnormalities (prediabetes or type 2 diabetes); Treatment with oral contraceptives or glucocorticoid therapy in the 3 months prior to inclusion in the study; Menarche at least three years prior to study entry; Previously known carbohydrate metabolism disturbances; Treatment with oral contraceptives or glucocorticoid therapy in the 3 months prior to inclusion in the study; Diagnosis of other serious chronic disease; Diagnosis of other serious chronic disease; Men with T1D and normal gonadal function of similar age, BMI, and duration of diabetes; Women with PCOS of similar age and BMI. INCLUSION CRITERIA; Women between 18 and 45 years old; Non-hyperandrogenic control women with regular menses of similar age and BMI. INCLUSION CRITERIA; Women between 18 and 45 years old; Honeymoon period of T1D; Pregnancy/lactation; Thyroid hormone dysfunction or hyperprolactinaemia; Diagnosis of non-classical congenital adrenal hyperplasia or other secondary causes of hyperandrogenism; Honeymoon period of T1D; Thyroid hormone dysfunction or hyperprolactinaemia; Diagnosis of non-classical congenital adrenal hyperplasia; Diagnosis of male hypogonadism; PCOS diagnosis based on the 2012 American NIH consensus criteria, including the Rotterdam and AE-PCOS; Pregnancy/lactation; Thyroid hormone dysfunction or hyperprolactinaemia; Diagnosis of non-classical congenital adrenal hyperplasia or other secondary causes of hyperandrogenism; Presence of regular menses; Lack of signs or symptoms of functional hyperandrogenism. EXCLUSION CRITERIA; Pregnancy/lactation; Thyroid hormone dysfunction or hyperprolactinaemia; Diagnosis of non-classical congenital adrenal hyperplasia or other secondary causes of hyperandrogenism.

Non--hyperandrogenic women with type 1 diabetes INCLUSION CRITERIA; Premenopausal women between 18 and 45 years old; Diagnosis of type 1a diabetes at least 12 months before inclusion in the study, confirmed by positive autoimmunity and complete insulin deficiency; Treatment with subcutaneous insulin therapy (multiple doses or continuous infusion); Availability of metabolic control data (continuous interstitial blood glucose monitoring) at least in the month prior to study entry; Menarche at least three years prior to study entry. EXCLUSION CRITERIA; Honeymoon period of T1D; Pregnancy or lactation; Thyroid hormone dysfunction or hyperprolactinaemia; Diagnosis of non-classical congenital adrenal hyperplasia or other secondary causes of hyperandrogenism; Diagnosis of other serious chronic disease; Treatment with oral contraceptives or glucocorticoid therapy in the 3 months prior to inclusion in the study; Women with type 1 diabetes and polycystic ovary syndrome INCLUSION CRITERIA; Women between 18 and 45 years old; Diagnosis of type 1a diabetes at least 12 months before inclusion in the study, confirmed by positive autoimmunity and complete insulin deficiency; Treatment with subcutaneous insulin therapy (multiple doses or continuous infusion); Availability of metabolic control data (continuous interstitial blood glucose monitoring) at least in the month prior to study entry; Menarche at least three years prior to study entry; PCOS diagnosis based on the 2012 American NIH consensus criteria, including the Rotterdam and AE-PCOS.

ClinicalTrials.gov NCT07490964