Pancreas volume is smaller in patients with type 1 diabetes than sex-, age-, and weight-matched controls.

<p>A) Pancreas volume, as determined from medical images, is smaller in patients with type 1 diabetes than matched controls (P < 0.0001). B) Pancreatic volume index, derived by dividing pancreas volume by subject body weight, is smaller in patients with type 1 diabetes than matched controls (P < 0.0001). C) Receiver operating characteristic curve indicates that pancreas volume and pancreas volume normalized by body weight, BMI, and BSA all discriminate patients with type 1 diabetes from matched controls (P < 0.0001). All four metrics provide similar diagnostic accuracy based upon c-index measurements.</p

Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes

<div><p>Aims</p><p>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.</p><p>Methods</p><p>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).</p><p>Results</p><p>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 pancreas volume over time (~ 6% of volume/year), whereas five controls scanned a year apart did not exhibit a decline in pancreas size (P = 0.03). The pancreas was uniformly smaller on the right and left side of the abdomen.</p><p>Conclusions</p><p>Pancreas volume declines with disease duration in patients with T1D, suggesting a protracted pathological process that may include the exocrine pancreas.</p></div

The pancreas volume in type 1 diabetes is reduced in both the right and left half of the abdomen.

<p>A) The abdomen was bisected by a midsagittal plane from spine to navel and pancreas volume was calculated for each half of the abdomen. B) The pancreas volume to the left of the spine and right of the spine were both smaller in patients with type 1 diabetes (P < 0.0005). C) The ratio of the pancreas volume to the left and right of the spine was similar in patients with type 1 diabetes and controls.</p

Pancreas volume is smaller with longer duration of type 1 diabetes.

<p>A) Pancreatic volume index is similar across the age range analyzed in control subjects (P = 0.56), but is smaller with age in patients with type 1 diabetes (P = 0.02). B) Patient age at the imaging scan correlates linearly with the duration of type 1 diabetes (P < 0.0001). C) Pancreatic volume index is smaller with increasing duration of type 1 diabetes (P = 0.04). D) In individual patients receiving multiple longitudinal imaging scans (N = 4) pancreatic volume index declines monotonically, whereas controls with repeated imaging scans do not display a decline in pancreas volume (P = 0.03).</p

Flowchart demonstrating criteria used to identify patient records for inclusion in the study.

<p>Flowchart demonstrating criteria used to identify patient records for inclusion in the study.</p

Demographic and Imaging Characteristics for Patients and Controls in This Study.

<p>Demographic and Imaging Characteristics for Patients and Controls in This Study.</p