Sonographic Evaluation of the Pancreas in Type 1 Diabetes Mellitus: A Case-control Study (original) (raw)
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Assessment of Pancreatic Sizes in Patients with Diabetes Mellitus: An Ultrasound Based Study
Acta Scientific Medical Sciences, 2021
Aims and Objectives: To evaluate the pancreatic size in diabetic patients and compare them with regular patients. Methodology: A prospective comparative study was conducted for six months, and 102 patients were included. Patients of type1DM, type2DM and control subjects were selected. The pancreas' ultrasound was performed on 27 healthy patients, 33 were with type 1 (Insulin-dependent diabetes mellitus), and 42 were type 2 (Non-insulin-dependent diabetes mellitus). Standard parameters of pancreatic size such as pancreatic head, pancreatic body, and pancreatic tail have been measured. The statistical analysis was performed using MedCalc. Results: The results show that the mean age was 37 years in the control group, the mean age was 50 years in the NIDDM group, and the mean age was ten years in the IDDM group. 37% were women, and 63% were men in the control sample. Although 36.4% were females and 63.6% in the IDDM community were males. Fifty-two percent were women, and in the NIDDM, 47 percent were men. Conclusion: Pancreatic size shows a decrease in type1DM and type2DM as compared to the control group. T1DM shows more noticeable changes compared to T2DM.
Pancreatic imaging by ultrasonography in type 1 diabetes mellitus
International journal of diabetes and metabolism, 2001
Various types of morphological changes in pancreas have been demonstrated in patients with type 1 diabetes mellitus. We evaluated 35 patients suffering from type 1 diabetes mellitus and compared them with 15 age, sex and BMI matched healthy controls to access the morphology of the pancreas by ultrasonography which is non-invasive, economic, simple and easily available. It was found that patients with type 1 diabetes mellitus have a reduction in total area of the pancreas, increased diameter of the main pancreatic duct and presence of fibrosis and calcification which was more pronounced in patients having longer duration of diabetes.
Radiology, 2018
Purpose To evaluate the association between increased pancreatic echogenicity (IPE) and the risk of glycemic progression and incident diabetes. Materials and Methods This retrospective study was approved by the institutional review board, with waiver of informed consent. Consecutive individuals who had undergone abdominal ultrasonography as part of a health examination at a tertiary hospital between January 2005 and December 2011 were included. IPE was defined as increased echogenicity of the pancreas compared with that of the left lobe of liver. Glycemic progression was defined as the development of new prediabetes or diabetes in normoglycemic participants or as new diabetes in prediabetic participants during the follow-up period (median, 3.17 years; interquartile range, 2.01-4.67 years). The occurrence of incident diabetes, defined as a new diagnosis of diabetes during follow-up, was also analyzed. Results Mean age of the 32 346 participants was 50.4 years ± 12.2, and 48% (15 489 ...
Morphopathology of Pancreas in Diabetes Mellitus- a Prospective Study Done in 50 Autopsy Cases
International Journal of Medical Laboratory Research, 2019
The pancreas comprises exocrine and endocrine compartments, with the latter comprising the pancreatic islet with its endocrine cells. In both type1 and type2 diabetes, several morphological changes occur in the pancreas, but the predominant feature of beta cell loss. Our aim of this study is to find out of histopathological changes in pancreas due to diabetes and correlate it with clinical findings. Methods: A prospective study was done on 50 autopsy specimens of pancreas. Specimens were fixed in formalin and tissue was adequately processed. The sections were stained with routine haematoxylene and eosin stain. Results: In our study 86% cases were of T1DM and 14% of T2DM. Most common age group was between 40-60 years (62% cases). 68% cases had duration of DM of 10-20 years. On histopathological examination, 85% Cases of T1DM revealed cytolysis and inflammation in exocrine pancreas. In cases of T2DM cytolysis was seen in 32% cases, inflammation in 25% and fibrosis in 16% cases.. Fibrosis was present in 14% cases of T1DM and 25% cases of T2DM in endocrine pancreas. Insulitis in endocrine pancreas was seen in 85% cases of T1DM and 34% cases of T2DM. Thus, the most common finding was reduced beta cell mass in T2DM and insulitis in T1DM. Findings were correlated with age, sex and duration of diabetes. Conclusion: With increasing incidence of diabetes knowledge of pathogenesis of changes due to diabetes in pancreas may lead to research of further targeted therapy in better management of diabetes in future. Changes that occur in pancreas due to diabetes are more evident in long standing diabetes and early changes are not evident in routine histopathological sections.
Pancreas volume and fat fraction in children with Type 1 diabetes
Diabetic Medicine, 2016
AimsPeople with Type 1 diabetes have smaller pancreases than healthy individuals. Several diseases causing pancreatic atrophy are associated with pancreatic steatosis, but pancreatic fat in Type 1 diabetes has not been measured. This cross‐sectional study aimed to compare pancreas size and fat fraction in children with Type 1 diabetes and controls.MethodsThe volume and fat fraction of the pancreases of 22 children with Type 1 diabetes and 29 controls were determined using magnetic resonance imaging.ResultsPancreas volume was 27% smaller in children with diabetes (median 34.9 cm3) than in controls (47.8 cm3; P < 0.001). Pancreas volume correlated positively with age in controls (P = 0.033), but not in children with diabetes (P = 0.649). Pancreas volume did not correlate with diabetes duration, but it did correlate positively with units of insulin/kg body weight/day (P = 0.048). A linear model of pancreas volume as influenced by age, body surface area and insulin units/kg body weig...
The role of pancreatic imaging in monogenic diabetes mellitus
| In neonatal diabetes mellitus resulting from mutations in EIF2AK3, PTF1A, HNF1B, PDX1 or RFX6, pancreatic aplasia or hypoplasia is typical. In maturity-onset diabetes mellitus of the young (MODY), mutations in HNF1B result in aplasia of pancreatic body and tail, and mutations in CEL lead to lipomatosis. The pancreas is not readily accessible for histopathological investigations and pancreatic imaging might, therefore, prove important for diagnosis, treatment, and research into these β-cell diseases. Advanced imaging techniques can identify the pancreatic features that are characteristic of these inherited diabetes subtypes, including alterations in organ size (diffuse atrophy and complete or partial pancreatic agenesis), lipomatosis and calcifications. Consequently, in patients with suspected monogenic diabetes mellitus, the results of pancreatic imaging could help guide the molecular and genetic investigation. Imaging findings also highlight the critical roles of specific genes in normal pancreatic development and differentiation and provide new insight into alterations in pancreatic structure that are relevant for β-cell disease.
Insulin Deficiency From Insulin Gene Mutation Leads to Smaller Pancreas
Diabetes Care
OBJECTIVE To determine the mechanism of reduced pancreas size in type 1 diabetes and the significance of islet-derived insulin in pancreatic growth. RESEARCH DESIGN AND METHODS Using a validated and standardized MRI protocol, we measured pancreas volume and shape in a family with an autosomal-dominant insulin gene mutation that results in insulin deficiency similar in severity to that of type 1 diabetes but without autoimmunity. DNA sequencing confirmed the mutation in all four affected individuals and none of the four control family members. Insulin secretory capacity was determined by measuring postprandial urinary C-peptide. RESULTS Family members with this form of monogenic diabetes had a markedly smaller pancreas and a severely impaired postprandial C-peptide level than family members without diabetes. CONCLUSIONS These results suggest that severe insulin deficiency, rather than islet-directed autoimmunity, leads to reduced pancreas size in type 1 diabetes and that insulin is a...
Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes
PloS one, 2016
This study harnessed the electronic medical record to assess pancreas volume in patients with type 1 diabetes (T1D) and matched controls to determine whether pancreas volume is altered in T1D and identify covariates that influence pancreas volume. This study included 25 patients with T1D and 25 age-, sex-, and weight-matched controls from the Vanderbilt University Medical Center enterprise data warehouse. Measurements of pancreas volume were made from medical imaging studies using magnetic resonance imaging (MRI) or computed tomography (CT). Patients with T1D had a pancreas volume 47% smaller than matched controls (41.16 ml vs. 77.77 ml, P < 0.0001) as well as pancreas volume normalized by subject body weight, body mass index, or body surface area (all P < 0.0001). Pancreatic volume was smaller with a longer duration of T1D across the patient population (N = 25, P = 0.04). Additionally, four individual patients receiving multiple imaging scans displayed progressive declines in...