What question did this study set out to answer?

To investigate the relationship between fibrosis and glycemic control in patients with chronic and acute recurrent pancreatitis undergoing islet autotransplantation.

June 7, 2026

3028-LB: Fibrosis Is Associated with Impaired Glycemia in Chronic Pancreatitis and Acute Recurrent Pancreatitis

Key Points

To investigate the relationship between fibrosis and glycemic control in patients with chronic and acute recurrent pancreatitis undergoing islet autotransplantation.
Analyzed pancreas biopsies from 84 patients with pancreatitis undergoing total pancreatectomy with islet autotransplantation (TPIAT).
Used Pearson's correlation and two-way ANOVA to assess associations between fibrosis, glycemic parameters, and islet mass.
Percent fibrosis calculated from H&E staining and ImageJ software.
Fibrosis correlated positively with pre-surgery HbA1c (r=0.335, p=0.0019) and negatively with islet equivalents transplanted per kg (r=-0.474, p<0.0001).
Diabetes mellitus participants exhibited greater fibrosis compared to normoglycemic group (65.92% vs 49.35%, p=0.019).
No significant association was found between fibrosis and C-peptide (p=0.15) or fasting glucose (p=0.10).

Abstract

Introduction and Objective: Pancreatogenic diabetes (T3cDM) is common in chronic pancreatitis, partially caused by beta cell loss and dysfunction due to fibrosis and inflammation. However, islet and pancreatic tissue pathology is rarely available to study. Methods: We analyzed fibrosis and glycemic and islet parameters in pancreas tissue biopsies from patients with recurrent acute or chronic pancreatitis undergoing total pancreatectomy with islet autotransplant (TPIAT) in the multicenter “POST” study. Standardized data for diabetes status and lab results, pancreatitis details, islet mass, and fibrosis were analyzed in a subset (n=84, age 35.38 +/- 15.44) representing male and female participants with normoglycemia, pre-diabetes mellitus (pre-DM), or diabetes mellitus (DM) (n=14 each). Percent fibrosis was calculated based on H0.0001), but no association with C-peptide (p=0.15) or fasting glucose (p=0.10). Males (65.79% +/- 3.883) had a larger percentage of fibrosis area compared with females (48.00% +/- 3.664) (p=0.0013). DM participants had more fibrosis than normoglycemia group (65.92% +/- 4.769 vs 49.35% +/- 4.962) (p=0.019). Conclusion: At time of TPIAT surgery, patients with greater fibrosis had impaired glycemic control and lower islet mass. Future work will evaluate for tissue markers of ER stress, autophagy, and bihormonality in CP beta cells with or without diabetes. Disclosure G. McFarlane: None. A. Eaton: None. S.A. Ahmad: None. G. Beilman: None. T.B. Gardner: None. K. Morgan: None. J.D. Nathan: None. B. Naziruddin: None. V. Singh: Advisory Panel; Current; Amgen Inc. Speaker's Bureau; Current; Amgen Inc. Advisory Panel; Current; Zenas BioPharma. Advisory Panel; Ended; Ionis Pharmaceuticals. Stock/Shareholder; Current; Kyttaro, Origin Endoscopy, Solv Endotherapy. G. Trikudanathan: Consultant; Current; Boston Scientific Corporation. M. Wijkstrom: Consultant; Current; Vertex Pharmaceuticals Incorporated. E. Alejandro: None. M.D. Bellin: Other - DSMB member; Current; Vertex Pharmaceuticals Incorporated. Advisory Panel; Current; Novo Nordisk, Sana Biotechnology Inc., Sernova, Corp. Research Support; Current; Dexcom, Inc. Funding National Institute of Diabetes and Digestive and Kidney Diseases(5R01DK109124)Department of Defense(HT9425-23-1-0307)National Institute of Diabetes and Digestive and Kidney Diseases(3R25DK140753-02S1)

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