{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:54:36Z","timestamp":1792482876819,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001429, UL1TR000064"],"award-info":[{"award-number":["KL2TR001429, UL1TR000064"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008871","name":"Juvenile Diabetes Research Foundation United States of America","doi-asserted-by":"publisher","award":["nPOD: 5-SRA-2018-557-Q-R"],"award-info":[{"award-number":["nPOD: 5-SRA-2018-557-Q-R"]}],"id":[{"id":"10.13039\/100008871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","award":["2018PG-T1D053"],"award-info":[{"award-number":["2018PG-T1D053"]}],"id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK123329, U01DK127392, R01DK122160, R01DK123292, UC4DK108132, R01DK120357"],"award-info":[{"award-number":["R01DK123329, U01DK127392, R01DK122160, R01DK123292, UC4DK108132, R01DK120357"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Access to human pancreas samples from organ donors has greatly advanced our understanding of type 1 diabetes pathogenesis; however, previous studies have shown that donors have a high rate of substance use, and its impact on pancreatic histopathology in this disease is not well described. One-hundred-thirty-one type 1 diabetes and 111 control organ donor pancreata from persons 12-89 years of age (mean 29.8 \u00b1 15.5 years) within the Network for Pancreatic Organ donors with Diabetes (nPOD) were examined for insulin positivity, insulitis, amyloid staining, acute and chronic pancreatitis, and chronic exocrine changes (acinar atrophy, fibrosis, fatty infiltration, or periductal fibrosis); findings were compared by history of substance use. A secondary analysis compared exocrine pancreatic histopathologic findings in type 1 diabetes versus control organ donors regardless of substance use history. We observed a high but congruent rate of substance use in type 1 diabetes and control organ donors (66.4% and 64% respectively). Among donors with type 1 diabetes (but not controls), islet amyloid (OR 9.96 [1.22, 81.29]) and acute pancreatitis (OR 3.2 [1.06, 9.63]) were more common in alcohol users while chronic exocrine changes (OR 8.86 [1.13, 69.31]) were more common in cocaine users. Substance use impacted the pancreata of donors with type 1 diabetes more than controls. Overall, despite similar rates of substance use, acute pancreatitis (15.3% versus 4.5%, p=0.0061), chronic pancreatitis (29.8% versus 9.9%, p=0.0001), and chronic exocrine changes (73.3% versus 36.9%, p&amp;lt;0.0001) were more common in type 1 diabetes donors than controls. Alcohol and\/or cocaine use in type 1 diabetes organ donors increases exocrine pancreas pathology and islet amyloid deposition but does not affect insulitis or insulin positivity. Exocrine pathology in type 1 diabetes donors is common, and further study of the pathophysiology of these changes is needed.<\/jats:p>","DOI":"10.3389\/fendo.2021.778912","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T13:27:32Z","timestamp":1638365252000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies"],"prefix":"10.3389","volume":"12","author":[{"given":"Brittany S.","family":"Bruggeman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Campbell-Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Filipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Gurka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Atkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond A.","family":"Schatz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Jacobsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12286","article-title":"Organ Donor Specimens: What can They Tell Us About Type 1 Diabetes","volume":"16","author":"Campbell-Thompson","year":"2015","journal-title":"Pediatr Diabetes"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0191528","DOI":"10.1371\/journal.pone.0191528","article-title":"Decreased \u03b1-Cell Mass and Early Structural Alterations of the Exocrine Pancreas in Patients With Type 1 Diabetes: An Analysis Based on the Npod Repository","volume":"13","author":"Bonnet-Serrano","year":"2018","journal-title":"PloS One"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2337\/db19-0554","article-title":"Temporal Analysis of Amylase Expression in Control, Autoantibody-Positive, and Type 1 Diabetes Pancreatic Tissues","volume":"69","author":"Kusmartseva","year":"2020","journal-title":"Diabetes"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0996","article-title":"High Illicit Drug Abuse and Suicide in Organ Donors With Type 1 Diabetes","volume":"40","author":"Jacobsen","year":"2017","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/1559827617722137","article-title":"Alcohol Use in Young Adults With Type 1 Diabetes","volume":"11","author":"White","year":"2017","journal-title":"Am J Lifestyle Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.16.1799","article-title":"Diabetic Ketoacidosis Associated With Cocaine Use","volume":"158","author":"Warner","year":"1998","journal-title":"Arch Intern Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0365","article-title":"Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry","volume":"43","author":"Kinney","year":"2020","journal-title":"Diabetes Care"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1177\/00258024211020936","article-title":"Methamphetamine Use and the Risk of Diabetic Ketoacidosis","author":"Lewis","year":"2021","journal-title":"Med Sci Law"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.17.1925","article-title":"Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes Mellitus: Clinical and Biochemical Differences","volume":"164","author":"Newton","year":"2004","journal-title":"Arch Intern Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.125","article-title":"North American Pancreatic Study Group. 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