University of Minnesota Clinical Center for the Study of Acute Pancreatitis and Diabetes

University Of Minnesota, Minneapolis MN

Investigators

Linked publications & trials

Abstract

Project Summary Diabetes mellitus (DM) occurring after one or more episodes of acute pancreatitis (AP) is an important cause of DM in adults, affecting about 15% of individuals by 2 years after an episode of AP. However, more rigorous data are needed in larger and more diverse populations to define the exact incidence of new DM, risk factors for developing DM, and pathophysiological mechanisms driving AP-related DM. To address this research gap, the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) formed the “Type 1 Diabetes Acute Pancreatitis Consortium” (T1DAPC) in 2020, which subsequently launched the Diabetes Related to Acute Pancreatitis and its Mechanisms (DREAM) study in 2022. The primary aims of the DREAM study are to estimate the prevalence of and clinical risk factors for DM after AP, characterize islet function and endocrine dysfunction after AP, and understand potential immunologic drivers of DM after AP. The University of Minnesota has been a successful clinical site in the T1DAPC, as evidenced by: (1) strong recruitment and exceptional retention (>95%) in DREAM; (2) leadership in the consortium including Co-Chairing the consortium and DREAM protocol (contact P.I. Bellin); and (3) proposals and contributions for ancillary studies and secondary data analyses. We will continue this important work in the next funding cycle of the T1DAPC. Our site-specific Aims for this proposal are: (1) To recruit and retain participants in the DREAM trial and to maintain academic engagement, collaboration, and leadership within the T1DAPC. We will continue to achieve a high level of participant engagement and retention in the DREAM study. (2) To determine whether CT-derived abdominal and pancreatic fat measures predict future development of DM and decline in beta cell function. We will use innovative machine learning approaches to estimate pancreatic, visceral and subcutaneous fat in the DREAM participants on initial CT imaging and determine its value in predicting later DM and beta cell function. (3) To define the role of beta cell function and insulin resistance in DM development after AP. We will use metabolic testing data collected in DREAM to determine metabolic pathways (reduced insulin secretion and/or insulin resistance) driving DM development. The results of DREAM will have a high impact in the clinical care of patients with AP, and are a first step towards developing screening, treatment, and ultimately prevention strategies for AP-related DM.