Pancreas size and exocrine function is decreased in young children with recent-onset Type 1 diabetes

Area of Science:

• Pediatric endocrinology
• Gastroenterology
• Diabetes research

Background:

• Type 1 diabetes (T1D) is an autoimmune disease primarily affecting insulin-producing beta cells in the pancreas.
• The role of the exocrine pancreas in the pathophysiology of early-onset T1D is not well understood.
• Early detection of pancreatic changes may offer insights into disease progression.

Purpose of the Study:

• To evaluate pancreatic size and exocrine function in children with recent-onset T1D.
• To investigate potential exocrine pancreatic involvement in the early stages of childhood diabetes.
• To correlate pancreatic morphology with exocrine function in pediatric T1D.

Main Methods:

• Ultrasound imaging was used to measure pancreatic transverse and longitudinal areas in 32 children with recent-onset T1D and 90 controls.
• Pancreatic faecal elastase-1 levels, a marker of exocrine function, were analyzed using ELISA.
• Study included children with T1D receiving insulin and controls, including first-degree relatives.

Main Results:

• Children with T1D exhibited significantly smaller pancreatic transverse (6.82 vs. 8.31 cm²) and longitudinal (1.28 vs. 1.55 cm²) areas compared to controls (P < 0.001 and P = 0.003, respectively).
• Pancreatic faecal elastase-1 levels were markedly reduced in children with T1D (455 ug/g) versus controls (1408 ug/g) (P < 0.001).
• These findings indicate reduced pancreatic size and subclinical exocrine dysfunction in early T1D.

Conclusions:

• Recent-onset Type 1 diabetes in young children is associated with reduced pancreatic area.
• Subclinical exocrine pancreatic dysfunction is present in children with early-onset T1D.
• These findings support the involvement of the exocrine pancreas in the pathophysiology of Type 1 diabetes presenting in early life.