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Aims/Introduction  A decrease in the size of the pancreas is observed in islet autoantibody‐positive non‐diabetic donors and acute‐onset type 1 diabetes irrespective of the diabetes duration. Little is known, however, about the relationship between the size of the pancreas and type 1 diabetes subtypes, including fulminant type 1 diabetes.    Materials and Methods  We examined the pancreatic volume ( PV ) in 44 adult patients with type 1 diabetes (16 acute‐onset type 1 diabetes, 18 slowly progressive type 1 diabetes and 10 fulminant type 1 diabetes) and 39 age‐ and body mass index‐matched non‐diabetic controls.  PV  was measured by computed tomography. The ability to secrete insulin was assessed by stimulated C‐peptide after intravenous glucagon administration.    Results   PV  was significantly correlated with bodyweight in both control participants and type 1 diabetes patients. The  PV  index ( PVI ;  PV /bodyweight) was decreased by 39% in type 1 diabetes compared with that in controls.  PVI  was significantly decreased in acute‐onset type 1 diabetes patients and slowly progressive type 1 diabetes patients (both  P  < 0.0001), but not in fulminant type 1 diabetes patients ( P  =   0.10), compared with control participants. In cases patients with recent‐onset type 1 diabetes (0–7 days post‐diagnosis),  PVI  was significantly decreased in acute‐onset type 1 diabetes patients ( n  = 8,  P  = 0.0005), but not in fulminant type 1 diabetes patients ( n  = 7,  P  = 0.44), compared with controls.  PVI  showed no correlations with the diabetes duration, C‐peptide levels, glycated hemoglobin, glutamic acid decarboxylase autoantibody levels, serum amylase or daily total insulin dose in type 1 diabetes subtypes.    Conclusions  The present results show that patients with acute‐onset type 1 diabetes and slowly progressive type 1 diabetes have small pancreases irrespective of the diabetes duration or C‐peptide levels. In contrast to earlier findings on acute‐onset type 1 diabetes, we found no reduction of  PVI  at the onset of fulminant type 1 diabetes.

Analysis of pancreatic volume in acute‐onset, slowly‐progressive and fulminant type 1 diabetes in a Japanese population