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High pancreatic fat content may lead to insulin dependence

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August 28, 2017

Insulin dependence was common among adults with increased pancreatic fat content who underwent total pancreatectomy with islet autotransplantation, and the condition may lead to beta-cell dysfunction, according to findings published in the Journal of Diabetes.

Joshua J. Wilhelm, MS, of the Schulze Diabetes Institute at the University of Minnesota, Minneapolis, and colleagues evaluated 79 adults undergoing total pancreatectomy with islet autotransplantation with low (n = 53) or high (n = 26) pancreatic fat content to determine whether pancreatic fatty infiltration has a negative effect on metabolic outcomes after surgery.

Fat area percentage was higher among participants with high pancreatic fat content (10.6%) compared with low pancreatic fat content (2.1%; P = .0009).

Insulin independence at 1 year was significantly higher in participants with low pancreatic fat content (32.7%) compared with participants with high pancreatic fat content (4%). The risk for full insulin dependence was higher in participants with high pancreatic fat content (70.8%) compared with participants with low pancreatic fat content (46.2%).

Participants with high pancreatic fat content had higher 1-hour glucose (P = .032) and 2-hour glucose (P = .027) levels after a mixed-meal tolerance test compared with participants with low pancreatic fat content. Beta score was lower in participants with high pancreatic fat content compared with participants with low pancreatic fat content (P = .034). No significant differences were found between the groups for daily average insulin dose, fasting glucose, HbA1c, fasting and stimulated C-peptide levels.

The researchers “observed markedly worse diabetes outcomes in patients with high pancreatic fat when compared to those with low pancreatic fat of similar age, gender and BMI.”

“This manifested as a low proportion of patients with insulin independence at 1 year, and a high proportion (over 70%) of patients requiring multiple daily insulin injections (insulin dependent), higher postprandial glucoses, and lower beta score in those with high fat content,” the researchers wrote. – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.

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