Why do patients with type 1 diabetes have the smallest pancreas?

The decision of an American family, offering to participate in a scientific investigation after three of their six children diagnose type 1 diabetes (insulin -dependent), has already resulted.

At the University of Vanderbilt they have discovered that insulin deficiency, regardless of immunity associated with type 1 diabetes is the main factor of having a smaller pancreas

Insulin is an important factor in determining the size of the pancreas and its loss leads to a much smaller pancreas, according to a study.

Twenty years after David and Ellen Pursell decided that their family would participate in an investigation, after they diagnose type 1 diabetes to three of their six children, a team of researchers from the University of Vanderbilt concludes in a study that the insulin deficit, apart from autoimmunity, it is the main factor that leads to a smaller pancreas.

Four members of this family of eight people living in Alabama (six children and marriage) have monogenic diabetes, due to a rare mutation in the insulin gene, which leads to a deficiency of this hormone without self -immunity.

The nuclear magnetic resonance (NMR) of the pancreas showed a small size and an altered shape in these people.It was similar to what had been previously observed in people with type 1 diabetes.

These findings that disseminate Diabetes Care shed light on the investigation of this disease that, as Professor David Moore, a member of this team, recalls "there are not many families, especially numerous, that have exactly this form of diabetes."

After volunteering in this study in 2003, they were surprised years later when a researcher at the Kovler Diabetes Center, from the University of Chicago, called them to tell them that scientific advances had revealed that the four, in reality, had monogenic diabetes due toA mutation in the insulin gene instead of type 1 diabetes.

Last year, researchers at the University of Vanderbilt who were collaborating with Siri Greley, in the Monogenic Diabetes Registry of the Kovler Diabetes Center, they contacted the Pursell to see if they could travel to Nashville to accurately measure their pancreas.

These scientists, together with Jack Virostko, from the University of Texas in Austin, found that the reduction in the size of the pancreas was present at the time of the diagnosis of type 1 diabetes.

Vanderbilt researchers also participated in an international team on multicentric evaluation of the pancreas in type 1 diabetes (MAP-T1D), to develop a standardized protocol of magnetic resonance images in order to evaluate the volume and microarchitecture of the pancreas.

"We know that the pancreas is much smaller in people with type 1 diabetes, but there have been no good models to understand exactly what happens," says Dr. Wright, of the Diabetes, Endocrinology and Metabolism Division and first author of the study.

"It is the first time that we can demonstrate in humans that insulin is an important factor in determining the size of the pancreas and its loss leads to a much smaller pancreas," he adds.

David and Ellen and their children, now adults, Peggy Rice, Vaughan Spanjer, Chrissy Adolf, Ramsey Nuss and their twin children Parker and Martin Pursell were measured the size of the pancreas using the standardized protocol of Vanderbilt magnetic resonance.David, Chrissy, Parker and Martin have monogenic diabetes.

This research has been possible thanks to the financing of the Institutes of Image Sciences and Clinical and Translational Research of the University of Vanderbilt, by Leona M. and Harry B. Helmsley Charitable Trust,Juvenile Diabetes Research Foundation, Doris Duke Charitable Foundation, Nih and Vanderbilt and Chicago Diabetes Research and Training Center.

   0