Pancreas Sonographic Findings Among Diabetic And Non-Diabetic Patients Attending Muhimbili National Hospital, Tanzania.
Authors: - Ngwilo B Mwakyusa , - Ramadhani R Kazema , - Balowa M Baraka 
Published: August 2024

Abstract
Background: Diabetic mellitus (DM) patients have various types of morphological changes occurring in the pancreas associated with a decrease in total pancreatic mass and ultrasound is the first-choice imaging modality for the pancreas. There are no documented studies done in Tanzania on ultrasound assessment of the pancreas in DM patients.

Objective: To determine pancreatic sonographic findings among Diabetic Mellitus and non-Diabetes Mellitus patients attending Muhimbili National Hospital diabetic clinic, Tanzania, from October 2017 to March 2018.

Methodology: This was a cross-sectional, hospital-based study conducted at the Radiology Department of Muhimbili National Hospital (MNH) involving DM and non-DM patients who attended the MNH diabetic clinic. Data was collected through a structured questionnaire, including the patient’s demographic characteristics, diabetes status, anthropometry measurement (weight, height, and BMI), and pancreas sonographic findings. Calipers on screen were used to measure AP dimensions of the pancreatic head, body, tail, and duct while pancreas echogenicity was evaluated by comparing it with liver echogenicity. SPSS version 20 was used for data analysis. P value of < 0.05 was considered statistically significant at 95% confidence interval. Ethical clearance was obtained from the MUHAS IRB (Institutional Research Board).

Results: A total of 120 patients participated in this study, of which 36 were males and 84 were females. Age ranged from 10-60 years old. Diabetic Mellitus was more prevalent among females than males in both DM type 1 and DM type 2 with 29 (72.5%) and 26(65%) respectively. The study shows that there were significantly lower AP dimensions of the body and tail of the pancreas (P=0.001) and (P=0.0001) respectively, in DM than in non-DM diabetes. There was a strong correlation between the increase in pancreatic head dimension and increased anthropometry measures (weight, height, and BMI) There was a strong significant decrease in the size of the pancreatic body and tail with an increase in duration of illness among Diabetic Mellitus patients in this study (P<0.01). Also, this study revealed significant changes in pancreas echogenicity, whereby DM type 2 was significantly associated with hyperechoic pancreatic head while DM type 1 was significantly associated with iso/hypoechoic pancreatic head. However, these changes in echogenicity were also age-related. Patients with infections or tumors involving the pancreas were excluded from the study

Conclusion: DM patients had smaller pancreas bodies and tails than non-DM. It was also noted DM type 1 had smaller dimensions of the pancreas (head, body, and tail) when compared to DM type 2 and non-DM. This study also showed increased pancreas head dimensions with increased weight, height, and BMI in DM patients. The present study showed a strong relation between increased duration of diabetic illness with decreased pancreatic body and tail dimensions.
Also, this study showed that the pancreas head echogenicity was significantly hypoechoic and hyperechoic in DM type 1 and DM type 2 respectively however age could be the contributing factor.