Background: Little is known about the pancreatic changes during type 1diabetes (T1D) progression. Recently shear wave elastography (SWE) has emerged as a tool of pancreatic stiffness assessment in chronic pancreatitis and pancreatic cancer with few studies assessing it in diabetes. Objective: to compare the pancreatic SWE in children with recent-onset and long standing T1D to healthy controls and to correlate it to diabetes-duration, glycemic control (HbA1C), functional B-cell reserve (fasting C-peptide) and diabetic complications. Methods: Fifty children with T1D (25 with recent-onset and 25 with long standing T1D) and 50 controls were enrolled. Diabetes-duration, insulin therapy, fundoscopic examination of the eyes and the neuropathy disability score were assessed. Fasting C-peptide, lipids, HbA1C and urinary albumin-creatinine ratio were measured. Pancreatic SWE was measured using logic-P9GE ultrasound-system. Results: The mean SWE of the studied children with recent-onset T1D is 4.81 ± 0.62 KPa, those with long standing T1D is 7.10 ± 1.56KPa, while that of the controls is 5.57 ± 0.27 KPa (P<0.001). SWE was positively correlated to diabetes duration (P<0.001) among children with T1D. Moreover, it was negatively correlated to fasting c-peptide (P<0.001). Regarding diabetes complications, SWE was positively correlated to severe hypoglycemia frequency (P=0.005), HbA1C (P=0.034), low-density lipoproteins (P<0.001) and cholesterol (P<0.001) and significantly related to diabetic neuropathy (P = 0.036) and nephropathy (P=0.049). Diabetes-duration, fasting C-peptide, HbA1C and severe hypoglycemia frequency were the significant independent variables related to SWE increase by multivariable regression analysis. Conclusion: Pancreatic SWE changes significantly during the course of T1D being lowest during recent onset T1D and highest in those with longstanding T1D; particularly those with diabetic nephropathy and neuropathy.
15 Sep 2022 - 17 Sep 2022