Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis

Clive H Wasserfall^{1

2}, Chris E Forsmark³, Shuang Li⁴, Liang Li⁴, Phil A Hart⁵, Mark O Goodarzi⁶, Yogish C Kudva⁷, Melena D Bellin⁸, Dhiraj Yadav⁹, Darwin L Conwell¹⁰, Jose Serrano¹¹, Dana K Andersen¹¹, William Fisher¹², Anna Casu¹³, Ken Cusi¹⁴, Steven J Hughes¹⁵, Evan Fogel¹⁶, Walter Park¹⁷, Stephen K Van Den Eeden¹⁸; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

Affiliations

¹ Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL.
² Department of Pediatrics, Diabetes Institute, University of Florida, Gainesville, FL.
³ Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL.
⁴ Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
⁵ Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH.
⁶ Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA.
⁷ Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN.
⁸ Division of Pediatric Endocrinology, University of Minnesota, Minneapolis, MN.
⁹ Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA.
¹⁰ Department of Medicine, University of Kentucky, Lexington, KY.
¹¹ Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
¹² Department of Surgery, Baylor College of Medicine, Houston, TX.
¹³ AdventHealth Translational Research Institute, Orlando, FL.
¹⁴ Division of Endocrinology, Diabetes, and Metabolism, University of Florida, Gainesville, FL.
¹⁵ Department of Surgery, University of Florida, Gainesville, FL.
¹⁶ Division of Gastroenterology and Hepatology, University of Indiana, Bloomington, IN.
¹⁷ Division of Gastroenterology and Hepatology, Stanford Medicine, Stanford, CA.
¹⁸ Division of Research, Kaiser Permanente Northern California, Pleasanton, CA.

PMID: 40633067
PMCID: PMC12365414 (available on 2026-09-01)
DOI: 10.2337/db24-0931

Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis

Clive H Wasserfall et al. Diabetes. 2025.

. 2025 Sep 1;74(9):1603-1612.

doi: 10.2337/db24-0931.

Authors

Affiliations

¹ Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL.
² Department of Pediatrics, Diabetes Institute, University of Florida, Gainesville, FL.
³ Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL.
⁴ Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
⁵ Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH.
⁶ Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA.
⁷ Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN.
⁸ Division of Pediatric Endocrinology, University of Minnesota, Minneapolis, MN.
⁹ Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA.
¹⁰ Department of Medicine, University of Kentucky, Lexington, KY.
¹¹ Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
¹² Department of Surgery, Baylor College of Medicine, Houston, TX.
¹³ AdventHealth Translational Research Institute, Orlando, FL.
¹⁴ Division of Endocrinology, Diabetes, and Metabolism, University of Florida, Gainesville, FL.
¹⁵ Department of Surgery, University of Florida, Gainesville, FL.
¹⁶ Division of Gastroenterology and Hepatology, University of Indiana, Bloomington, IN.
¹⁷ Division of Gastroenterology and Hepatology, Stanford Medicine, Stanford, CA.
¹⁸ Division of Research, Kaiser Permanente Northern California, Pleasanton, CA.

PMID: 40633067
PMCID: PMC12365414 (available on 2026-09-01)
DOI: 10.2337/db24-0931

Abstract

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.

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Conflict of interest statement

Duality of Interest. C.E.F. is a consultant for Nestle Health and has received research support from AbbVie. K.C. has received research support toward the University of Florida as principal investigator from Boehringer Ingelheim, Echosens, Inventiva, and LabCorp., and is a consultant for Aligos, Arrowhead, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, GSK, Lilly, Novo Nordisk, Prosciento, Sagimet, and Siemens. Y.C.K. has received research support toward the Mayo Clinic Rochester as principal investigator from Dexcom and Tandem Diabetes and is a consultant for Novo Nordisk, Vertex Pharmaceuticals, and Tandem Diabetes. M.D.B. serves on advisory or monitoring boards for Vertex and NovoNordisk and receives research support from Viacyte and Dexcom. M.O.G. has served on advisory boards for Nestle Health and Organon. D.Y. serves as a consultant for Pfizer and has received research support from AbbVie. No other potential conflicts of interest relevant to this article were reported.

References

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Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis

Affiliations

Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis

Authors

Affiliations

Abstract

Conflict of interest statement

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