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Mechanisms overlapping with those of type 2 diabetes have been explored, including insulin resistance and insulin deficiency. However, autoimmune mechanisms in response to unmasking \u03b2-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.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>ARTICLE HIGHLIGHTS<\/jats:title>\n                    <jats:p>Type 1 diabetes\u2013associated 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/db24-0931","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T20:41:02Z","timestamp":1752093662000},"page":"1603-1612","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":4,"title":["Type 1 Diabetes Autoantibodies in Acute, Recurrent Acute, and Chronic Pancreatitis"],"prefix":"10.2337","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3522-8932","authenticated-orcid":false,"given":"Clive H.","family":"Wasserfall","sequence":"first","affiliation":[{"name":"Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida 1 , Gainesville, FL"},{"name":"Department of Pediatrics, Diabetes Institute, University of Florida 2 , Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris E.","family":"Forsmark","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, University of Florida 3 , Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The University of Texas MD Anderson Cancer Center 4 , Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The University of Texas MD Anderson Cancer Center 4 , Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil A.","family":"Hart","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center 5 , Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark O.","family":"Goodarzi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center 6 , Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogish C.","family":"Kudva","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic 7 , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melena D.","family":"Bellin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, University of Minnesota 8 , Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Yadav","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh 9 , Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darwin L.","family":"Conwell","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky 10 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Serrano","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases 11 , Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana K.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases 11 , Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine 12 , Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Casu","sequence":"additional","affiliation":[{"name":"AdventHealth Translational Research Institute 13 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Cusi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, University of Florida 14 , Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Florida 15 , Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Fogel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Indiana 16 , Bloomington, 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