Regnell SE, et al. Diabet Med. 2016;doi:10.1111/dme.13115.

Children with type 1 diabetes — even with a short disease duration — have smaller pancreatic volume vs. children without diabetes, but the size difference is not associated with pancreatic fat fraction, according to recent study findings.

In an imaging analysis of 51 children with and without diabetes, Simon E. Regnell, MD, a PhD student at Lund University Clinical Research Center in Malmö, Sweden, and colleagues analyzed pancreatic volume and fat fraction in 22 children aged at least 10 years with type 1 diabetes and no known exocrine pancreas disorders (10 girls; mean age, 14 years; mean diabetes duration, 5.9 years) and 29 controls (18 girls; mean age, 12 years) using MRI between May 2012 and November 2013. Researchers found pancreatic volume was 27% smaller in children with type 1 diabetes (median, 34.9 cm³) vs. controls (47.8 cm³; P < .001). No between-group differences were found for pancreatic fat fraction (1.34% vs. 1.57%; P = .891).

Pancreas volume correlated positively with age in controls (P = .033), but not in children with diabetes (P = .649). Pancreas volume also did not correlate with diabetes duration, but it was associated with units of insulin per kilogram of body weight per day (P = .048).

In a linear model relating pancreas volume to age, body surface area and units of insulin per kilogram of body weight per day, the effect of insulin per kilogram per day was independent of the other two variables (P = .009)

“Our observation that the daily insulin dose in relation to body weight correlated with the pancreas volume may suggest that the pancreas atrophies as the body produces progressively less insulin during the subclinical loss of [beta]-cell function, but [can] be maintained once systemic insulin levels have been normalized by therapeutic administration after diabetes onset,” the researchers wrote. “This would be consistent with the hypothesis that reduced pancreas size in type 1 diabetes is caused by the missing trophic effect of insulin on pancreatic tissue.”

Disclosure: The researchers report no relevant financial disclosures.                                                        


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