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Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
Brittany S Bruggeman1,2, Martha Campbell-Thompson2,3, Stephanie L Filipp4
1Department of Pediatrics, Division of Endocrinology, University of Florida, Gainesville, FL, United States.
Frontiers in Endocrinology
|December 16, 2021
Summary
Substance use in organ donors with type 1 diabetes is linked to increased exocrine pancreas damage and islet amyloid. This study highlights the impact of alcohol and cocaine on pancreatic histopathology in type 1 diabetes.
Area of Science:
- Endocrinology and Metabolism
- Gastroenterology and Hepatology
- Pathology
Background:
- Human pancreas samples from organ donors are crucial for understanding type 1 diabetes.
- Previous research indicates a high prevalence of substance use among organ donors.
- The specific impact of substance use on pancreatic histopathology in type 1 diabetes remains underexplored.
Purpose of the Study:
- To investigate the association between substance use and pancreatic histopathology in organ donors with and without type 1 diabetes.
- To compare exocrine pancreatic changes in type 1 diabetes donors versus control donors.
- To determine if substance use affects islet amyloid deposition and insulitis in type 1 diabetes.
Main Methods:
- Analysis of 131 type 1 diabetes and 111 control organ donor pancreata from the Network for Pancreatic Organ donors with Diabetes (nPOD).
- Histopathological examination for insulin positivity, insulitis, amyloid staining, pancreatitis, and chronic exocrine changes.
- Comparison of findings based on substance use history and between type 1 diabetes and control groups.
Main Results:
- Substance use rates were similar in both type 1 diabetes (66.4%) and control (64%) donors.
- In type 1 diabetes donors, alcohol use was associated with increased islet amyloid and acute pancreatitis.
- Cocaine use was linked to chronic exocrine changes in type 1 diabetes donors.
- Type 1 diabetes donors showed significantly higher rates of acute pancreatitis, chronic pancreatitis, and chronic exocrine changes compared to controls, irrespective of substance use.
Conclusions:
- Substance use, particularly alcohol and cocaine, exacerbates exocrine pancreas pathology and islet amyloid deposition in type 1 diabetes organ donors.
- These findings suggest that substance use significantly impacts pancreatic health in individuals with type 1 diabetes.
- Further research is warranted to elucidate the pathophysiology of these substance use-induced pancreatic changes in type 1 diabetes.
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