A post-hoc analysis of a subset of adult participants in a randomized trial showed that changes in pancreas volume and shape occurred during 2 years of remission of type 2 diabetes (T2D) with weight management intervention. The analysis included 90 T2D participants randomly assigned to a weight management intervention (n=64) or control (n=26) and were assessed at baseline; a further 25 non-diabetic participants were enrolled into a non-diabetic comparator (NDC) group. Magnetic resonance techniques were employed to quantify pancreas volume, the irregularity of the pancreas borders, and intrapancreatic fat content. The pancreas is small and irregular in shape in T2D patients. At baseline, mean pancreas volume was 61·7 cm 3 in all participants with T2D and 79·8 cm 3 in the NDC group. At 24 months, pancreas volume had increased by 9·4 cm 3 in responders (HbA 1c <6·5% and fasting blood glucose <7·0 mmol/L, off all anti-diabetes medication) compared with 6·4 cm 3 in non-responders. Pancreas borders at baseline were more irregular in participants with T2D than in the NDC group (fractal dimension 1·138 vs 1·097) and had normalized by 24 months in responders only (1·099). Intrapancreatic fat declined by 1·02% in 32 responders and 0·51% in 13 non-responders. These data show the reversibility of the abnormal pancreas morphology of T2D by weight loss-induced remission. Source: https://www.thelancet.com/
