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Pancreas size and exocrine function is decreased in young children with recent‐onset Type 1 diabetes
Author(s) -
Augustine P.,
Gent R.,
Louise J.,
Taranto M.,
Penno M.,
Linke R.,
Couper J. J.
Publication year - 2020
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13987
Subject(s) - medicine , type 1 diabetes , diabetes mellitus , endocrinology , type 2 diabetes , pancreas , subclinical infection , exocrine pancreatic insufficiency , gastroenterology
Aims To measure pancreatic area and exocrine function in young children with recent‐onset Type 1 diabetes to determine whether the exocrine pancreas is also affected in the pathophysiology of early childhood diabetes. Methods Thirty‐two children (14 boys) aged 5.5 (4.5, 7.3) median ( IQR ) years presenting with recent‐onset Type 1 diabetes and 90 controls (44 boys) of similar age had ultrasound imaging of the pancreas. Children with Type 1 diabetes were receiving insulin and were without ketosis. Transverse and longitudinal areas of the pancreas were measured by digitalized outline. Pancreatic faecal elastase‐1 was analysed using an enzyme‐linked immunosorbent assay kit in recent‐onset Type 1 diabetes and 38 first‐degree relative control children. Results Pancreatic area and exocrine function were reduced in Type 1 diabetes. Mean transverse area ( SD ) in Type 1 diabetes was 6.82 cm 2 (1.61) vs. 8.31 cm 2 (1.74) in controls, adjusted estimate (95% CI ) 1.45 (‐2.12, ‐0.79), P < 0.001; longitudinal area was 1.28 cm 2 (0.44) vs. 1.55 cm 2 (0.43), adjusted estimate (95% CI ) ‐0.27 (‐0.45, ‐0.09), P = 0.003. Faecal elastase‐1 levels in Type 1 diabetes were 455 (323, 833) ug/g, median ( IQR ) vs. 1408 μg/g (1031, 1989) in controls, P < 0.001. Conclusion Pancreatic area and accompanying subclinical exocrine function were reduced in very young children with recent‐onset Type 1 diabetes. This supports changes in the exocrine pancreas in the pathophysiology of Type 1 diabetes presenting in early life.