Introduction and Objective: The islet microvasculature is dysfunctional in type 1 diabetes (T1D) and characterizing islet loss in early stage T1D may guide intervention. Contrast enhanced ultrasound (CEUS) in pre-clinical models has shown changes in pancreas blood flow dynamics, which predicted the speed of T1D progression and the effect of immunotherapies. Less is known about the use of CEUS in human T1D. Methods: We enrolled 32 patients (15 control, 10 multiple islet autoantibody positive (Aab+), and 7 new onset T1D) who underwent CEUS via a ‘destruction-replenishment’ protocol with DEFINITY contrast. We characterized demographic data and CEUS reperfusion metrics for all participants. We classified glycemic risk in Aab+ participants with logistic regression models of longitudinal OGTT area under the curve (AUC) and T1D and CEUS covariates. Results: Participants (n=32) were 34±12 years at enrollment, 69% female, 81% White, 32% had the DR3-DQ2 and 55% the DR4-DQ8 haplotypes. CEUS indicated 2 Aab+ participants with deviation (95% CI) from control participants, who had increasing glucose OGTT AUC (Figure). Insulin Aab (OR 2.0 95% CI: 1.2 - 3.3, p=0.035) was associated with increasing OGTT AUC and CEUS metrics had an OR of 2.0 95% CI:0.99 -4.00 p=0.08). Conclusion: Preliminary studies using CEUS in Aab+ adults identifies individuals with increasing dysglycemia. Further studies are warranted to test if CEUS could improve characterization of T1D progression. Disclosure T.M. Triolo: None. K. HartMoore: None. L. Galvez Valencia: None. H. Broncucia: None. A.B. Stein: None. R.K. Benninger: None. Funding American Diabetes Association (11-22-ICTSPM-02), NIDDK (K23 DK136931)
Triolo et al. (Fri,) studied this question.