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Small pancreas size linked to faster progression to stage 3 Type 1 diabetes, finds study
Overview
A multicenter, longitudinal study has discovered that a small pancreas size predicts a faster progression to stage 3 Type 1 diabetes (T1D), the point at which clinical diagnosis occurs.
Published in the American Diabetes Association’s journal Diabetes Care, the study demonstrates that pancreas size is an early marker of risk for T1D progression and that pancreas imaging can have a benefit in tracking disease development and recruitment for preventive and therapeutic trials.
The team, co-led by investigators at the Vanderbilt Diabetes Research and Training Center (DRTC), found that using pancreas volume measurement combined with validated metabolic T1D risk measures can more accurately predict disease development than either method alone.
“By the time a person has developed stage 3 Type 1 diabetes, there is significant beta cell loss and symptoms are usually present,” said lead author Jack Virostko, PhD, assistant professor of Diagnostic Medicine in the Dell Medical School at the University of Texas at Austin, formerly with the Vanderbilt University Institute of Imaging Science. “If we can better predict the progression to stage 3, our hope is that we can better identify and apply therapies to slow or even stop the advance of the disease, even before diagnosis.”
Researchers evaluated the pancreatic volume of 65 TrialNet participants using non-contrast magnetic resonance imaging (MRI), metabolic scores from oral glucose tolerance testing (OGTT) and a combination of pancreas volume and metabolic scores to predict progression to stage 3 T1D in individuals with multiple diabetes-related autoantibodies.
“We investigated whether MRI measurement of pancreas volume in individuals identified as being at risk of Type 1 diabetes could predict progression to stage 3 disease and how these imaging measures correlated with metabolic testing,” said Vanderbilt University Medical Center (VUMC) site investigator Daniel Moore, PhD, MD, associate professor of Pediatrics and of Pathology, Microbiology and Immunology. “Our results suggest small pancreas volume can predict progression to stage 3 Type 1 diabetes, with discrimination similar to that of measurements derived from oral glucose tolerance testing and the Diabetes Prevention Trial–Type 1 Risk Score (DPTRS), a prediction tool validated by TrialNet.”
“Of note, pancreas volume and metabolic measures were not correlated, suggesting that they reflect different aspects of the disease process underlying T1D and provide different information regarding disease risk. Our prediction model, using both pancreas volume and metabolic measures, outperformed imaging or metabolic testing alone for predicting progression to stage 3 Type 1 diabetes.
Reference: DOI: 10.2337/dc23-1681