Journal of diabetes investigation 2018 02 10() doi 10.1111/jdi.12816
A decrease in the size of the pancreas is observed in islet autoantibody-positive non-diabetic donors and acute-onset type 1 diabetes (AT1D) irrespective of the diabetes duration. Little is known, however, about the relationship between the size of the pancreas and T1D subtypes, including fulminant T1D (FT1D).
We examined the pancreatic volume (PV) in 44 adult patients with T1D (16 AT1D, 18 slowly progressive [SPT1D], and 10 FT1D) and 39 age- and BMI- matched non-diabetic controls. PV was measured by computed tomography. The ability to secrete insulin was assessed by stimulated C-peptide after intravenous glucagon administration.
PV was significantly correlated with body weight (BW) in both controls and T1D. The pancreatic volume index (PVI: PV/BW) was decreased by 39% in T1D compared to that in controls. PVI was significantly decreased in AT1D and SPT1D (both P <0.0001), but not in FT1D (P = 0.10), compared to controls. In cases with recent-onset T1D (0-7 days postdiagnosis), PVI was significantly decreased in AT1D (n = 8, P = 0.0005), but not in FT1D (n = 7, P = 0.44), compared to controls. PVI showed no correlations with the diabetes duration, C-peptide levels, HbA1c, glutamic acid decarboxylase autoantibody levels, serum amylase, or daily total insulin dose in T1D subtypes. CONCLUSIONS
The present results indicate that patients with AT1D and SPT1D have small pancreases irrespective of the diabetes duration or C-peptide levels. In contrast to earlier findings on AT1D, we found no reduction of PVI at the onset of FT1D. This article is protected by copyright. All rights reserved.