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Pancreatic perfusion and subsequent response to glucose in healthy individuals and patients with type 1 diabetes
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Division of Molecular Imaging.
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2016 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 59, no 9, p. 1968-1972Article in journal (Refereed) Published
Abstract [en]

AIMS/HYPOTHESIS: The aim of this study was to investigate pancreatic perfusion and its response to a glucose load in patients with type 1 diabetes mellitus compared with non-diabetic ('healthy') individuals.

METHODS: Eight individuals with longstanding type 1 diabetes and ten sex-, age- and BMI-matched healthy controls underwent dynamic positron emission tomography scanning with (15)O-labelled water before and after intravenous administration of glucose. Perfusion in the pancreas was measured. Portal and arterial hepatic perfusion were recorded as references.

RESULTS: Under fasting conditions, total pancreatic perfusion was on average 23% lower in the individuals with diabetes compared with healthy individuals. Glucose increased total pancreatic and portal hepatic blood perfusion in healthy individuals by 48% and 38%, respectively. In individuals with diabetes there was no significant increase in either total pancreatic or portal hepatic perfusion.

CONCLUSIONS/INTERPRETATION: Individuals with type 1 diabetes have reduced basal pancreatic perfusion and a severely impaired pancreatic and splanchnic perfusion response to intravenous glucose stimulation.

Place, publisher, year, edition, pages
2016. Vol. 59, no 9, p. 1968-1972
Keywords [en]
Blood flow; Glucose; Pancreas; Pancreatic islets; Perfusion; Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-297684DOI: 10.1007/s00125-016-4016-2ISI: 000380668800021PubMedID: 27306617OAI: oai:DiVA.org:uu-297684DiVA, id: diva2:942967
Funder
Swedish Research Council, K2013-55-X-15043-10-5 K2015-54X-12219-19-4 K2013-64X-08268-26-3Swedish Diabetes AssociationSwedish Child Diabetes FoundationNovo Nordisk
Note

De 2 sista författarna delar sistaförfattarskapet

Available from: 2016-06-27 Created: 2016-06-27 Last updated: 2018-01-25Bibliographically approved
In thesis
1. Positron Emission Tomography and Magnetic Resonance Techniques in Diabetes
Open this publication in new window or tab >>Positron Emission Tomography and Magnetic Resonance Techniques in Diabetes
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In order to further advance the field of diabetes research there is a great need for establishing validated non-invasive quantitative techniques to study the pancreas and other tissues of importance for blood glucose regulation. The general aim of this thesis was to explore magnetic resonance techniques and positron emission tomography as such tools.

In paper I pancreatic perfusion under basal conditions and in response to glucose in nondiabetic and type 1 diabetic individuals was studied with [15O]H2O PET/CT. Individuals with type 1 diabetes were found to have reduced basal pancreatic perfusion and a severely impaired pancreatic and splanchnic perfusion response to intravenous glucose stimulation.

In paper II four groups of subjects at different stages of type 2 diabetes development and a control group of individuals without diabetes were examined with PET/CT and MRI. The [11C]5-HTP uptake in pancreas was hypothesized to correlate with remaining functional capacity of the β-cells. The progressive loss of β-cell function indicated by metabolic testing was not mirrored by a decrease in [11C]5-HTP tracer accumulation in the pancreas. This provides evidence of retained islet mass despite decreased β-cell function, indicating that β-cell dysfunction or dedifferentiation, and not necessarily endocrine cell loss, constitutes a major cause of β-cell failure in type 2 diabetes.

In paper III the feasibility of using ex-vivo MR spectroscopy for assessment of viability of human pancreas grafts prior to transplantation was studied. It was found that 31P-MRS may provide quantitative parameters for evaluating graft viability ex vivo, and is a promising tool for objective non-invasive assessment of the quality of human pancreas grafts.

In paper IV the Imiomics method for automatic image analysis was validated in whole-body [18F]-FDG PET/MR images in subjects with varying degree of insulin resistance. Imiomics was found to provide association screening and timesaving analysis of whole-body data and detected differences in glucose uptake and tissue composition between subjects on voxel-level. However, it did not show complete correlation with traditional volume of interest based tissue analysis in a small cohort.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 61
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1422
Keywords
Positron emission tomography, Magnetic resonance imaging, Magnetic resonance spectroscopy, Type 1 diabetes, Type 2 diabetes, PET/MR, Pancreas transplantation, Perfusion
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology
Identifiers
urn:nbn:se:uu:diva-340008 (URN)978-91-513-0223-2 (ISBN)
Public defence
2018-03-15, Rosénsalen, ingång 95/96, Akademiska sjukhuset, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-02-21 Created: 2018-01-25 Last updated: 2018-03-07

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Carlbom, LinaEspes, DanielLubberink, MarkEriksson, OlofJohansson, LarsJansson, LeifKorsgren, OlleAhlström, HåkanCarlsson, Per-Ola

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Carlbom, LinaEspes, DanielLubberink, MarkEriksson, OlofJohansson, LarsJansson, LeifKorsgren, OlleAhlström, HåkanCarlsson, Per-Ola
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RadiologyDepartment of Medical Cell BiologyDivision of Molecular ImagingClinical ImmunologyTransplantation and regenerative medicine
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