3D imaging of human pancreas suggests islet size and endocrine composition influence their loss in type 1 diabetes

The current paradigm in Type 1 diabetes (T1D) research centers around the autoimmune destruction of insulin-producing β-cells in the pancreas. This preprint works within this established paradigm.

This research utilizes advanced 3D imaging techniques (light sheet fluorescent microscopy) to investigate the size, composition, and distribution of pancreatic islets in individuals with and without T1D, including those at risk. The study confirms the expected loss of β-cells in T1D but contributes detailed observations about the heterogeneity of islet composition and size, suggesting that smaller islets and those lacking other endocrine cell types (like glucagon-producing α-cells) are preferentially lost. This work refines the understanding of β-cell loss in T1D within the existing paradigm of autoimmune destruction, adding nuance and detail without challenging the fundamental assumptions of the field. Therefore, it is classified as "Normal Science" as it contributes to the puzzle-solving activity within the current paradigm, characterizing the process of islet loss with greater precision than previously possible.