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Diabetes Care. 2019 Feb;42(2):248-257. doi: 10.2337/dc18-1507. Epub 2018 Dec 14.

Pancreas Volume Declines During the First Year After Diagnosis of Type 1 Diabetes and Exhibits Altered Diffusion at Disease Onset.

Author information

1
Department of Diagnostic Medicine, Dell Medical School, University of Texas at Austin, Austin, TX jack.virostko@austin.utexas.edu al.powers@vanderbilt.edu daniel.moore@vanderbilt.edu.
2
Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
3
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN.
4
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
5
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
6
Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN.
7
Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN jack.virostko@austin.utexas.edu al.powers@vanderbilt.edu daniel.moore@vanderbilt.edu.
8
Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN.
9
VA Tennessee Valley Healthcare System, Nashville, TN.
10
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN jack.virostko@austin.utexas.edu al.powers@vanderbilt.edu daniel.moore@vanderbilt.edu.
11
Department of Pathology, Immunology, and Microbiology, Vanderbilt University, Nashville, TN.

Abstract

OBJECTIVE:

This study investigated the temporal dynamics of pancreas volume and microstructure in children and adolescents with recent-onset type 1 diabetes (T1D) and individuals without diabetes, including a subset expressing autoantibodies associated with the early stages of T1D.

RESEARCH DESIGN AND METHODS:

MRI was performed in individuals with recent-onset stage 3 T1D (n = 51; median age 13 years) within 100 days after diagnosis (mean 67 days), 6 months, and 1 year postdiagnosis. Longitudinal MRI measurements were also made in similarly aged control participants (n = 57) and in autoantibody-positive individuals without diabetes (n = 20). The MRI protocol consisted of anatomical imaging to determine pancreas volume and quantitative MRI protocols interrogating tissue microstructure and composition.

RESULTS:

Within 100 days of diabetes onset, individuals with T1D had a smaller pancreas (median volume 28.6 mL) than control participants (median volume 48.4 mL; P < 0.001), including when normalized by individual weight (P < 0.001). Longitudinal measurements of pancreas volume increased in control participants over the year, consistent with adolescent growth, but pancreas volume declined over the first year after T1D diagnosis (P < 0.001). In multiple autoantibody-positive individuals, the pancreas volume was significantly larger than that of the T1D cohort (P = 0.017) but smaller than that of the control cohort (P = 0.04). Diffusion-weighted MRI showed that individuals with recent-onset T1D had a higher apparent diffusion coefficient (P = 0.012), suggesting a loss of cellular structural integrity, with heterogeneous pancreatic distribution.

CONCLUSIONS:

These results indicate that pancreas volume is decreased in stages 1, 2, and 3 of T1D and decreases during the first year after diabetes onset and that this loss of pancreatic volume is accompanied by microstructural changes.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT03585153.

PMID:
30552135
PMCID:
PMC6341292
[Available on 2020-02-01]
DOI:
10.2337/dc18-1507

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