Clinical, Radiologic and Biochemical Factors Related to Diabetes Development after Acute Pancreatitis

PROJECT SUMMARY/ABSTRACT Approximately 15-25% of patients develop diabetes after an initial episode of acute pancreatitis (AP). Studies on risk factors for diabetes development post-AP have yielded inconsistent results, highlighting methodological gaps. The Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC) formed in 2020 to determine the epidemiology and clinical characteristics, beta cell function and immunologic mechanisms of diabetes occurring after AP through the longitudinal Diabetes RElated to Acute pancreatitis and its Mechanisms (DREAM) study. As a clinical center (CC), we have been recruiting and following subjects for the DREAM study since 2022 and the ancillary IMaging Morphology of Pancreas in DIabetic PatieNts following AcutE PaNcreaTitis (IMMINENT) study since 2023. This proposal is being submitted in response to RFA-DK-25-017 which is a continuation of the T1DAPC-CC and consists of the following three aims: Aim 1: To further enhance recruitment and retention of subjects for the prospective longitudinal observational clinical study, DREAM of the T1DAPC; Aim 2: To attain the target subject accrual for the IMMINENT and Diabetes RElated to Acute Pancreatitis and its Mechanisms: Metabolic Outcomes Using Novel CGM Metrics (DREAM-ON) ancillary studies of the T1DAPC; and Aim 3: To conduct a pilot study to identify AP-specific autoantigen and neoantigen signatures, exploring immune mechanisms associated with type 1 diabetes (T1D) following AP. The first two aims focus on continuing and enhancing recruitment and follow-up of subjects for DREAM and its ancillary studies. The final aim is contingent on approval by the T1DAPC steering committee and availability of funding. Successful completion of the DREAM and ancillary studies will greatly improve our understanding of the diabetes that occurs after AP.