A new MRI-based study published in the Diabetes has revealed that insulin deficiency, rather than the specific type of diabetes, is the key driver of reduced pancreas volume in individuals with diabetes. The findings offer fresh insight into how insulin signaling influences pancreatic structure and highlight the exocrine consequences of severe insulin deficiency in both type 1 diabetes (T1D) and monogenic forms of diabetes, including permanent neonatal diabetes (PND) and maturity-onset diabetes of the young (MODY).

Using a standardized and validated MRI protocol, researchers measured pancreas volumes in 37 individuals with various types of monogenic diabetes, such as HNF4A-MODY, GCK-MODY, HNF1A-MODY, HNF1B-MODY, INS-MODY, and INS-PND, and compared them with previously studied groups of 93 individuals with T1D and 90 healthy controls.

Patients with INS-PND or HNF1B-MODY had smaller pancreas volumes than those without diabetes. Patients requiring insulin therapy had significantly smaller pancreas sizes than those not requiring insulin across all forms of monogenic diabetes.