{"doi":"10.2337/db24-0931","title":"Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis","abstract":"Pancreatogenic or type 3c diabetes, which occurs as a consequence of pancreatitis, may have several mechanisms. Mechanisms overlapping with those of type 2 diabetes have been explored, including insulin resistance and insulin deficiency. However, autoimmune mechanisms in response to unmasking β-cell antigens, similar to those of type 1 diabetes (T1D), have not been thoroughly examined. We performed cross-sectional T1D autoantibody profiling in a large prospective cohort (N = 927) of adults with acute, recurrent acute, or chronic pancreatitis. We examined correlations of prevalence of autoantibodies against GAD (GAD antibody), IA-2 (IA-2 antibody), zinc transporter 8 (ZnT8; ZnT8 antibody), and insulin (insulin autoantibody [IAA]) with clinical and demographic features, including presence of diabetes, diabetes treatment, and family history of diabetes. Diabetes was present in 11 (12%) of 94 participants with acute pancreatitis, 69 (27%) of 273 with recurrent acute pancreatitis, and 235 (43%) of 560 with chronic pancreatitis. Among these groups, islet autoantibodies were respectively found in five (5.3%) of 94, 48 (17.6%) of 273, and 127 (22.6%) of 560. The proportions of individuals with diabetes who were autoantibody positive were 45%, 70%, and 54%, respectively (most commonly IAA, which may reflect exogenous insulin use). However, across the entire cohort, 27 participants (2.9%) had two, two (0.2%) had three, and one (0.1%) had four T1D-associated autoantibodies, respectively, suggesting a potential pathogenic link that should be further explored. ARTICLE HIGHLIGHTS Type 1 diabetes–associated autoimmune mechanisms have not been thoroughly examined in pancreatitis-associated diabetes. We assessed the prevalence of four islet autoantibodies in serum from a large prospective cohort of patients with acute, recurrent acute, or chronic pancreatitis. Diabetes was present in 11 (12%) of 94 participants with acute pancreatitis, 69 (27%) of 273 with recurrent acute pancreatitis, and 235 (43%) of 560 with chronic pancreatitis. Excluding those with only insulin autoantibody positivity, which is confounded by insulin treatment, islet autoantibodies were identified in 51 (5.5%) of 927 participants, and 30 (3.2%) of 297 were positive for two or more autoantibodies. Our findings suggest pancreatitis may elicit islet autoimmunity in a subset of patients, necessitating prospective longitudinal follow-up.","journal":"Diabetes","year":2025,"id":526212,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9612,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":367757,"name":"Chris E. Forsmark","orcid":null,"position":1,"is_corresponding":false},{"id":881094,"name":"Shuang Li","orcid":"0000-0002-9193-0320","position":2,"is_corresponding":false},{"id":922781,"name":"Liang Li","orcid":"0000-0002-0687-074X","position":3,"is_corresponding":false},{"id":229729,"name":"Phil A. Hart","orcid":null,"position":4,"is_corresponding":false},{"id":270034,"name":"Mark O. Goodarzi","orcid":"0000-0001-6364-5103","position":5,"is_corresponding":false},{"id":231682,"name":"Yogish C. Kudva","orcid":"0000-0003-0285-6622","position":6,"is_corresponding":false},{"id":7392,"name":"Melena D. Bellin","orcid":"0000-0002-7324-4837","position":7,"is_corresponding":false},{"id":262316,"name":"Dhiraj Yadav","orcid":"0000-0001-7078-9893","position":8,"is_corresponding":false},{"id":1247457,"name":"Darwin L. Conwell","orcid":"0000-0002-4845-7769","position":9,"is_corresponding":false},{"id":1393001,"name":"J.L. Serrano","orcid":"0000-0002-6545-9395","position":10,"is_corresponding":false},{"id":640224,"name":"Dana K. Andersen","orcid":"0000-0002-9714-8671","position":11,"is_corresponding":false},{"id":702532,"name":"William Fisher","orcid":"0000-0003-0592-781X","position":12,"is_corresponding":false},{"id":924498,"name":"Anna Casu","orcid":"0000-0001-6924-0617","position":13,"is_corresponding":false},{"id":1402270,"name":"Ken Cusi","orcid":null,"position":14,"is_corresponding":false},{"id":374591,"name":"Steven J. Hughes","orcid":"0000-0002-5688-6942","position":15,"is_corresponding":false},{"id":371645,"name":"Evan L. Fogel","orcid":"0000-0003-0998-8257","position":16,"is_corresponding":false},{"id":438248,"name":"Walter G. Park","orcid":"0000-0001-8187-4188","position":17,"is_corresponding":false},{"id":233926,"name":"Stephen K. Van Den Eeden","orcid":"0000-0002-5599-8387","position":18,"is_corresponding":false},{"id":477240,"name":"Clive Wasserfall","orcid":"0000-0002-3522-8932","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T02:50:30.402772Z","pmid":"40633067","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}