Pancreas size, shape can return to normal in diabetes remission, study says
Reversing type 2 diabetes can restore the pancreas to its normal size and shape, a new study finds.
Previous research found that with remission of type 2 diabetes through significant weight loss, natural insulin-production can return to levels similar to people who have never had diabetes.
The new study is the first to show that reversing diabetes can also affect the size and shape of the pancreas, the researchers said.
The study included 64 people with type 2 diabetes and a control group 64 people without diabetes whose pancreas health was monitored for two years. At the start of the study, average pancreas volume was 20% smaller and organ borders were more irregular in people with diabetes than in the control group.
After five months of weight loss, pancreas volume was unchanged in people with diabetes who’d gone into remission — responders — as well as those who had not. But after two years, the pancreas had grown by an average of one-fifth in responders, but only about 1/12th in non-responders, the findings showed.
Responders also lost a significant amount of fat from their pancreas, at 1.6%, compared with non-responders, at around 0.5%, and achieved normal pancreas borders, the study found.
Only responders showed early and sustained improvement in beta-cell function, which is key to making and releasing insulin. After five months of weight loss, responders were making more insulin and levels were maintained at two years. There was no change in non-responders.
The findings were presented recently at an online annual meeting of the European Association for the Study of Diabetes. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.
“Our previous research demonstrated the return to long-term normal glucose control, but some experts continue to claim that this is merely ‘well-controlled diabetes’ despite our demonstration of a return to normal insulin production by the pancreas,” said study leader Roy Taylor, a professor of medicine and metabolism at Newcastle University in the United Kingdom.
“However, our new findings of major change in the size and shape of the pancreas are convincing evidence of return to the normal state,” he added.
Taylor noted in an association news release that large amounts of insulin cause tissues to grow or at least maintain their size.
“Normally, inside the pancreas the amounts of insulin present after a meal are very high. But in type 2 diabetes this does not happen. This new study suggests that achieving remission of type 2 diabetes restores this healthy, direct effect of insulin on the pancreas,” Taylor said.
It’s not clear why diabetes remission doesn’t occur in all patients who lose weight, said Elizabeth Robertson, director of research at Diabetes UK, which funded the study.
Type 2 diabetes affects one in 11 — or 415 million — adults worldwide.
The American Diabetes Association has more on type 2 diabetes.
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