bluuebunny/crossref_metadata_2025_split huggingface dataset:
2092-P: Impact of Insulin Resistance on Response to a Meal by Salience, Executive Control, and Default Mode Resting State Networks in Humans
Authors: SEWAYBRICKER LETICIA ESPOSITO , MELHORN SUSAN J. , ASKREN MARY K. , WEBB MARY , TYAGI VIDHI , DE LEON MARY ROSALYNN , GRABOWSKI THOMAS J. , SCHUR ELLEN 
Published: June 2019

Functional connectivity (fc) in the Salience Network (SN) is reduced by a meal. We hypothesized that disengagement of the SN may be mirrored by increased fc in Executive Control (ECN) or Default Mode (DMN) networks (representing a switch away from interoceptive neural processing after feeding) and that insulin resistance might impact shifts in postprandial neural processing. Subjects (N=111) oversampled for obesity had body composition, fasting glucose and insulin evaluated and underwent resting-state fMRI before and after a standardized meal. Masks for ECN (Seeley2007) and DMN (Grecius2003) were applied to obtain the fc pre-, post-meal and change (%). Subgroups with low (N=37) and high (N=36) HOMA-IR were created from tertiles. Among all subjects (28±9 y; BMI 30.5±6 kg/m2), ECN fc was reduced by a meal (z=-2.9, P=0.004), but DMN fc did not change (z=-0.02, P=0.98). The low and high HOMA-IR groups had mean BMIs of 26.8 and 34.7±5. Fc response to a meal, adjusted for age, sex and fat mass, did not differ between low and high HOMA groups for ECN (group*time chi2(1)=2.39, PInt=0.12) or SN (chi2(1)=2.52, PInt=0.11); both groups reduced fc. However, for DMN a group*time was found (chi2(1)=9.12, PInt=0.003, adjusted), such that the low HOMA group increased post-meal fc (Fisher z-score 0.36 vs. 0.41, P=0.04), but high HOMA group decreased fc (0.37 vs. 0.31, P=0.03). Change (%) in connectivity was positively correlated among all 3 networks (P&lt;0.002). A significant interaction for DMN vs. ECN (P=0.02) by HOMA group was present. Participants with high HOMA had a blunted correlation between DMN and ECN (coef=0.12, P=0.28) compared to those with low HOMA (coef=0.61, P=0.001).
Fc was reduced by a meal in the ECN and not modified in the DMN on average. However, DMN fc increased with feeding in non-insulin resistant individuals as hypothesized, but decreased in those with insulin resistance, suggesting that insulin resistance impacts shifts in neural processing in response to a meal.

Disclosure
L.E. Sewaybricker: None. S.J. Melhorn: None. M.K. Askren: None. M. Webb: None. V. Tyagi: None. M. De Leon: None. T.J. Grabowski: None. E. Schur: None.

Funding
American Diabetes Association (1-17-ICTS-085 to E.S.); Sao Paulo Research Foundation (2017/00657-0); National Institutes of Health (DK089036, DK098466); University of Washington Nutrition Obesity Research Center (P30 DK035816); Diabetes Research Center (P30DK017047); Institute of Translational Health Sciences (UL1TR000423)
2099-P: Assessing the Link between Metabolic Phenotype and Skeletal Muscle Index (SMI) in Obese and Nonobese Adults
Authors: ONAL-TASTAN YESIM , DIZMAN NAZLI , ERTUR ESEN , CAKIR-GUNEY BASAK , SARGIN MEHMET , OGUZ AYTEKIN 
Published: June 2019

Background: Sarcopenia is strongly linked to impaired metabolic health. However, sarcopenia might be omitted in patients (pts) with metabolic syndrome which is commonly predominated by obesity. We seek to identify associates of low muscle mass in regard metabolic health and obesity.
Methods: Consecutive pts who presented to internal medicine outpatient clinics of a tertiary hospital for regular follow-up were included in this study. Those with comorbidities that are known to cause secondary sarcopenia such as chronic liver and kidney disease, inflammatory diseases and cancers were excluded. SMI was measured by bioelectrical impedance analysis (TANITA MC780) Pts with at least two components of metabolic syndrome were considered metabolically unhealthy. SMI values of metabolic healthy (MH) and unhealthy (MUH) patient groups were compared across obese and non-obese adults. Multivariate regression analysis was performed to identify factors related to low muscle mass.
Results: Amongst 200 pts (M:F 97:103) included in this study, median age was 49,9 ± 8. Mean SMI was 8.9±0.6 (F:M 8.3:9.5) The MUH phenotype was more frequent in pts with low muscle mass compared to those with normal muscle mass (p=0.048) Obesity was not associated with low muscle mass regardless of MH (p=0.345) Mean SMI was lower in MUH pts regardless of presence of obesity. After controlling the mentioned variables, multivariate analysis didn’t demonstrate an independent effect of MUH phenotype on low SMI but a trend towards effect was observed (Odds ratio[OR]:1.09 Confidence Interval[CI] 95% 0.95-9.51 p=0.062). High waist to hip ratio was the factor independently associated with low SMI (OR: 8.328, CI 95% 8.23-20.43 p=0.009).
Conclusion: Our results identify an association between impaired metabolical health and low muscle mass regardless of the presence of obesity. Most interestingly we observed an interplay between central obesity and impaired muscle mass that warrants further exploration in larger samples.

Disclosure
Y. Onal-Tastan: None. N. Dizman: None. E. Ertur: None. B. Cakir-Guney: None. M. Sargin: None. A. Oguz: None.
210-LB: Evaluation of Two Commercially Available Glycated Hemoglobin Methods
Authors: GOMEZ PAZMIÑO BETTY J. , VERA LORENTI FANNY E. , GUADALUPE VARGAS MARIANA E. , ALVAREZ CONDO GRACIELA M. , VERON DOLORES , CERCADO ALICIA G. , RODAS NEIRA EDGAR I. , BAHAR BURAK , VERON DELMA 
Published: June 2019

HbA1c level reflects chronic glycemic status if reliable tests are used. The HbA1c testing improved with the efforts of many national and international organizations; however, in some regions, high performing assays might not be readily available. Here we report a comparison study of two immunoassay methods with a high-performance liquid chromatography (HPLC) assay, all of them available in Ecuador. We studied 114 fresh whole-blood samples from adults with normal and pathological HbA1c levels. HbA1c was measured in all samples by DCA-Vantage point-of-care analyzer, I-Chroma portable fluorescent scanner immunoassay and BioRad Variant II Turbo HPLC. Blood samples with variants of hemoglobin were excluded. HbA1c values were expressed in National Glycohemoglobin Standardization Program percentages and mmol/mol, as mean ± standard deviation.
Results: HbA1c measurements by HPLC and DCA-Vantage were similar: 6.3±1.7% (45±18.6 mmol/mol) vs. 6.3±1.8% (45±19.7 mmol/mol), respectively, P=0.057, while HbA1c values by I-Chroma were lower than HPLC, 5.8±1.9% (40±20.8 mmol/mol), P&lt;0.001. Interestingly, the coefficient of variation was below 2% for high and low HbA1c levels, in all methods studied, demonstrating high precision. HbA1c values by HPLC and DCA-Vantage were highly correlated, Kendall's Correlation Coefficient [KCC]: 0.817, whereas the correlation among HPLC and I-chroma was weak, KCC: 0.294. The mean bias between DCA-Vantage and HPLC was -0.02±0.29% (-0.2±3.2 mmol/mol), 95% Confidence Interval of the differences (CID) [0.55%, -0.60%] (6.0 mmol/mol, -6.6 mmol/mol) while for I-Chroma and HPLC the mean bias was -0.50±1.62% (-5.5±17.7 mmol/mol), 95% CID [2.74%, -3.74 %] (30 mmol/mol, -40.9 mmol/mol). Conclusion: HbA1c results by DCA-Vantage were comparable to HPLC, showing a good correlation, an appropriate precision and a low bias. While I-Chroma assay was precise but inaccurate. Our results suggest a significant need for improvement in HbA1c immunoassays currently in use in our country, Ecuador.

Disclosure
B.J. Pazmiño Gomez: None. F.E. Vera Lorenti: None. M.E. Guadalupe Vargas: None. G.M. Alvarez Condo: None. D. Veron: None. A.G. Cercado: None. E.I. Rodas Neira: None. B. Bahar: None. D. Veron: None.

Funding
Ministry of Higher Education, Science, Technology and Innovation, Ecuador/Prometeo Project/State University of Milagro, Ecuador (UNEMI-OCAS-SO-27092013-N?26 DV2013?2014, UNEMI-OCAS-SO-03072014-N8-DV2014-2015, UNEMI-OCAS-SO-30052016-N5-DV2015-2017)
2105-P: Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup, 2009-2015
Authors: KIM YANG-HYUN , YOO SOON JIB , LEE SEONG-SU 
Published: June 2019

Background: Waist circumference (WC) is an index of abdominal obesity and associated with co-morbidities and mortality. Higher WC is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality.
Methods: A total of 23,263,878 subjects (men = 11,813,850 and women = 11,450,028) who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85-90 cm in men and 80-85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC.
Results: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65-85 years than subjects aged 40-65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1.156, 1.412, and 1.614 in normal BMI and 1.145, 1.401, and 1.909 in overweight, respectively).
Conclusion: There was a linear association between WC and all-cause mortality across all BMI categories even in the subjects with normal or overweight BMI. Physicians should check WC routinely even in the subjects with normal weight or overweight.

Disclosure
Y. Kim: None. S. Yoo: None. S. Lee: None.
2108-P: Model-Based Assessments of Glucose Metabolism in Morbid Obese (MO) Subjects Before and After Bariatric Surgery (BS)
Authors: BRIX JOHANNA , KRZIZEK EVA-CHRISTINA , TURA ANDREA , PACINI GIOVANNI , LUDVIK BERNHARD 
Published: June 2019

Improvement of insulin resistance (IR) as contributor of diabetes remission and prevention is a well known beneficial effect of BS. We investigated the changes in IR and sensitivity (IS) in MO patients with newly diagnosed type 2 diabetes (DM) before and 2 years after BS and compared the changes to patients with either impaired fasting glucose or impaired glucose tolerance (IGT/IFG). We included 27 patients with DM (mean age 44±12 years, mean±SD, BMI 49± 10kg/m²) and 104 patients with IGT/IFG (mean age 41±11 years, BMI 47± 7kg/m²). All patients had a 75g oGTT, glucose and insulin levels were repeatedly measured for calculation of IR and IS indices (Table). BMI (p= 0.742) and age (p= 0.194) were not different between both groups. Indices are shown in the Table. Before BS, IR was significantly higher in DM for all indices (p&lt;0.001), except for AUC insulin (p=0.631). After BS, there were no significant differences in AUC glucose (p= 0.454), HOMA (p=0.905) OGIS (p=0.355), Matsuda (p= 0.469) and the oral disposition Index (0.171). IGT/IFG patients had a higher AUC insulin (p= 0.024) and a lower IGI (p= 0.024) compared to DM. Newly diagnosed DM patients are more insulin resistant compared to IGT/IGF. BS reduces IR to the same level in both groups. Post-glucose challenge AUC insulin remained higher in IGT/IFG, indicating better pancreatic insulin secretion reserve, which might translate to better diabetes prevention.

Disclosure
J. Brix: None. E. Krzizek: None. A. Tura: None. G. Pacini: None. B. Ludvik: Advisory Panel; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Sanofi, Takeda Development Centre Europe Ltd. Research Support; Self; Akebia Therapeutics, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S. Speaker's Bureau; Self; Merck Sharp & Dohme Corp.
2109-P: Symptomatic and Asymptomatic Hypoglycemia following Three Different Bariatric Procedures Is a Frequent and Severe Complication
Authors: KNOBLER HILLA , LAZAR LI OR , SAPOJNIKOV SHIMON , PINES GUY , MAVOR ELI , OSTROVSKY VIVIANA , SCHILLER TAL , ZORNITZKI TAIBA 
Published: June 2019

Background: Post-bariatric surgery hypoglycemia has been previously reported. However, its prevalence remains uncertain due to variability of diagnostic criteria, types of bariatric procedures and possible lack of awareness.
Objective: To determine the frequency and severity of symptomatic and asymptomatic hypoglycemia in persons following 3 different surgical procedures ≥ 1 years before evaluation, and a group of non-operated obese persons.
Design and Setting: Observational cohort study conducted at an out-patient clinic. Fifty-one consecutive individuals were enrolled: post Roux-en-Y gastric bypass (RYGB) (n=16), post omega loop gastric bypass (OLGB) (n=12), post sleeve gastrectomy (SG) (n=15), obese persons prior to surgery (controls) (n=8). Hypoglycemic events (blood glucose ≤ 54 mg/dL) and severe hypoglycemia (blood glucose ≤ 40 mg/dL) were evaluated by: symptoms' questionnaire, mixed meal tolerance test (MMT) and continuous glucose monitoring (CGM).
Results: According to questionnaires, meal-related complaints were reported in 11 (26%) of the surgical group and 1/8 of controls. During MMT, 88%, 82% and 67% experienced hypoglycemia in the RYGB, OLGB and SG groups respectively, vs. none in the controls (P &lt; 0.001). Severe hypoglycemia occurred in 38%, 45% and 7% of the RYGB, OLGB and SG groups respectively, (P= 0.025) but only 10 of the total operated group (24%) reported any symptoms. During CGM, fasting hypoglycemic events occurred more in the RYGB and OLGB vs. the SG group: 55%, 63% vs.17% respectively, (P= 0.036).
Conclusions: Post-bariatric surgery hypoglycemia is a very common phenomenon after 3 types of bariatric surgery and can be severe especially following bypass procedures. Intriguingly, our results show that hypoglycemia occurs not only in postprandial but also in fasting state, especially following bypass procedures. In many cases there were no specific complaints that may lead to underestimation of this serious complication.

Disclosure
H. Knobler: Advisory Panel; Self; AstraZeneca, Novo Nordisk A/S. L. Lazar: None. S. Sapojnikov: None. G. Pines: None. E. Mavor: None. V. Ostrovsky: None. T. Schiller: Advisory Panel; Self; Novo Nordisk Inc., Sanofi-Aventis. T. Zornitzki: None.
2115-P: Impact of Body Weight Change on Glycemic Control and Lipid Profiles in Obese Japanese Patients with Type 2 Diabetes
Authors: YOSHIMURA RAN , HASEGAWA YUKIKO , NAKAGAMI TOMOKO , BABAZONO TETSUYA 
Published: June 2019

Objective: Body weight (BW) reduction is recommended for improvement of metabolic control in obese patients with type 2 diabetes (T2D). However, it is not fully understood to what extent of BW reduction is sufficient in Japanese. The aim of the study was to assess the impact of BW change on glycemic control and lipid profiles in obese Japanese patients with T2D.
Methods: The study subjects were 684 patients (65% men, mean age 59 years) with a body mass index (BMI) ≥25 kg/m2 among 8,179 patients with T2D who visited our diabetes clinic in both 2013 and 2015-2016. The changes in the levels for casual blood glucose (CBG), HbA1c, serum lipids, BW and proportions of patients taking medications (oral hypoglycemic agents and injection) between baseline and follow-up periods were determined. The liner regression analysis was performed to assess the relation of the changes in BW and changes in CPG, HbA1c, and serum lipid profiles. ANOVA and ANCOVA were used to compare these changes across five groups classified by the changes in BW as &lt;-3% (n=195), -3 to -1% (n=138), -1 to 1% (n=126), 1 to 3% (n=78), and ≥3% (n=146).
Results: During the observational period, median values for BMI, CPG, HbA1c, triglyceride (TG), and LDL-cholesterol (LDL-C) were significantly decreased and HDL-C was significantly increased (all p&lt;0.01). Changes in medications were observed in 72% of the patients. Multivariable liner regression analysis showed significant relations between the changes in BW and the changes in TG (beta=0.12, p&lt;0.01) and LDL-C (beta =0.081, p=0.04). The adjusted mean change in TG in the five groups classified by the changes in BW were -7.8, 1.4, 6.8, 11.2, and 17.5%, and significant difference was found between the groups of BW &lt;-3 and ≥3%. There was no difference in change in other parameters across the five groups.
Conclusion: In obese Japanese patients with T2D, change in BW was closely associated with change in TG and LDL-C, with statistically significant change in TG in those exhibiting -3% decrease in BW.

Disclosure
R. Yoshimura: None. Y. Hasegawa: None. T. Nakagami: None. T. Babazono: None.
2126-P: Physiological Concentrations of IL-1 Beta Promote Islet Amyloid Deposition by Increasing Beta-Cell Secretion of Human Islet Amyloid Polypeptide
Authors: TEMPLIN ANDREW T. , MELLATI MAHNAZ , ZEMAN-MEIER DANIEL , HOGAN MEGHAN F. , ESSER NATHALIE , ZRAIKA SAKENEH , HULL REBECCA L. , KAHN STEVEN E. 
Published: June 2019

Aggregation of the β-cell secretory product human islet amyloid polypeptide (hIAPP) results in islet amyloid deposition as observed in type 2 diabetes (T2D). Formation of islet amyloid is associated with increased expression of proinflammatory cytokines and contributes to β-cell dysfunction and death. We previously showed that physiological levels of IL-1β increase inflammatory marker expression and islet amyloid deposition in isolated hIAPP transgenic mouse islets, a model of islet amyloidosis in T2D. To confirm these findings, we cotreated hIAPP transgenic islets with a physiological dose of IL-1β (4 pg/ml) and an IL-1β neutralizing antibody (1 μg/ml) for 48 h. Cotreatment reduced amyloid deposition by 55% compared to IL-1β alone (1.64±0.36 vs. 3.64±0.68% amyloid area per islet area, n=4, p=0.04), indicating this effect is dependent on IL-1β. Given that physiological levels of IL-1β have been shown to increase insulin secretion, we hypothesized they also stimulate IAPP secretion and thereby provide a mechanism for increased islet amyloid formation and inflammation. Islets treated with 4 pg/ml IL-1β secreted increased amounts of both insulin and IAPP over 48 h compared to vehicle treated islets (insulin: 87.5±8.9 vs. 48.3±17.3 nM/5 islets, n=4, p=0.04; IAPP: 409 ± 82 vs. 165 ± 51 pM/5 islets, n=4, p=0.02). Although IL-1β treated islets exhibited significant reductions in Ins2 (0.47 ± 0.03 vs. 1.01 ± 0.08, n=9, p&lt;0.01) and Iapp (0.75 ± 0.06 vs. 1.01 ± 0.10, n=9, p=0.03) mRNA expression, content of insulin and IAPP was unchanged after 48 h (insulin: 167.9±14.2 vs. 144.3± 24.6 nM/5 islets, n=4, p=0.44; IAPP: 2272 ± 296 vs. 2340 ± 419 pM/5 islets, n=4, p=0.9).
In summary, physiological levels of IL-1β promote islet amyloid deposition, likely by increasing β-cell secretion of IAPP. Neutralization of this effect of IL-1β may therefore decrease the deleterious effects of amyloid formation on β-cell function and survival.

Disclosure
A.T. Templin: None. M. Mellati: None. D. Zeman-Meier: None. M.F. Hogan: None. N. Esser: None. S. Zraika: Research Support; Self; Novartis Pharmaceuticals Corporation. R.L. Hull: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. S.E. Kahn: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S. Consultant; Self; Neurimmune. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S.

Funding
U.S. Department of Veterans Affairs (BX001060); National Institutes of Health (F32DK107022)
2129-P: DAP-Related Apoptosis-Inducing Kinase-2 Negatively Regulate Islet Beta-Cell Function by Autophagy Repression
Authors: LU YUTING , LI JINGYA , LI JIA 
Published: June 2019

Islet apoptosis is a detrimental event causing or aggravating type 2 diabetes (T2D). The attenuation of islet β cells is always accompanied by the development of T2D. Current clinical antidiabetic drugs are shown to be effective, but they have not fundamentally solved the essence of islet cellular apoptosis and failure. Therefore, it is necessary to identify novel targets and potential therapeutics for hyperglycemic treatment with significant protection/delay islet function attenuation. DAP-related apoptosis-inducing kinase-2 (Drak2) is a member of death-associated protein kinase (DAPK) family. We found higher expression of Drak2 in pancreas of db/db mice compared with littermites. We demonstrated that Drak2 activity was negatively related with glucose-stimulated insulin secretion (GSIS) and the autophagic flux by knockdown or overexpression of Drak2 in primary islets. To further investigate the role of Drak2 in islet function, we generated β cell-specific Drak2 knockout mice (βKO) model. We found that the capacity of glucose tolerance was enhanced in βKO mice. And Drak2-deficient islets can resistant to palmitate-triggered apoptosis and GSIS impairment. On the other hand, Drak2 inhibitors were applied in the efficacy study, we demonstrated that these compounds effectively protected islets from apoptosis via autophagy promotion in vitro and ameliorated T2D in vivo in mouse models. Mechanistically, Drak2 may be involved in autophagy regulation through autophagy initiation complex, ULK1, to exerting its effects on the function and apoptosis of islet cells. Our preliminary work show that inhibition or deficiency of Drak2 protects β cell from apoptosis may due to autophagy promotion, and suggest that Drak2 might be a novel target for potential diabetic therapeutics development.

Disclosure
Y. lu: None. J. Li: None. J. Li: None.

Funding
Shanghai Municipal Science and Technology Commission (16430711700)
2138-P: Pancreatic Exocrine Changes in Longstanding Type 1 Diabetes
Authors: WRIGHT JORDAN J. , SAUNDERS DIANE C. , LINDNER JILL , BOGDANI MARIKA , BRISSOVA MARCELA , BOTTINO RITA , POWERS ALVIN C. 
Published: June 2019

Individuals with longstanding type 1 diabetes (T1D) have smaller pancreata. Recent studies have found that pancreas volume is less at the time of T1D diagnosis and slightly decreased in auto-antibody positive, nondiabetic (ND) individuals. The reduced pancreas size in T1D cannot be due solely to β cell loss, since islets make up only ~2% of total pancreas mass. To better understand the T1D pancreas, we studied the pancreatic endocrine and exocrine compartments from T1D donors (N=23; age 18-62 years; duration 10-45 years) and age-matched, ND controls (N= 20; age 18-55 years). During islet isolation from T1D pancreata, standard approaches and enzymes were quite inadequate to free most islets or disperse the exocrine tissue. We also noted that T1D pancreata were more firm in physical consistency and had reduced relative pancreas weight (RPW, gm pancreas per kg body weight; 0.63 ± 0.04 in T1D vs. 1.1 ± 0.1 in ND, p&lt;0.001) and volume (55.7 ± 7.2 vs. 99.9 ± 9.1 cc, p=0.001, n=21 and 11). The RPW did not correlate with T1D duration. Acinar cell density per tissue section was similar in T1D and ND (7400 ± 306 vs. 7502 ± 247 cells/mm2; n=11 per group; p=0.8), but T1D pancreata had fewer total cells as expressed per pancreatic mass (3.4 ± 1.7 vs. 5.8 ± 0.8 x 1010 cells, p=0.02, n=11 and 10). T1D acinar cells tended toward reduced size compared to ND acinar cells (86.1 ± 2.6 vs. 94.0 ± 3.8 μm2, p=0.055, n=8 and 10); acinar cell size did not correlate with pancreas weight, RPW, or proximity to islets. TUNEL and Ki67-positive exocrine cells were rare in both T1D and ND. Trichrome staining showed a qualitative increase in connective tissue in the exocrine compartment of T1D pancreata compared to ND, though specific staining for collagen IV and laminin appeared similar. Collectively these data illustrate exocrine-specific changes to pancreata in longstanding T1D, including an increase in connective tissue and a reduced pancreas size due to a reduction in total acinar cell number. How, when and why these changes occur in the T1D exocrine compartment remain to be determined.

Disclosure
J.J. Wright: None. D.C. Saunders: None. J. Lindner: None. M. Bogdani: None. M. Brissova: None. R. Bottino: Research Support; Self; Imagine Pharma. A.C. Powers: None.