This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Type 1 diabetes results from the autoimmune destruction of the insulin-producing beta cells contained within the islets of Langerhans in the pancreas. This autoimmune process occurs over a variable number of years, eventually leading to clinically detectable disease. Once diabetes develops, the body can no longer make enough insulin to regulate blood sugar appropriately. The autoimmune destruction of islets and associated inflammatory changes in patients with overt diabetes may last for several years into the disease course, until the beta cell destruction is near total. At present, this process can only be directly detected with invasive pancreatic biopsies. The purpose of this pilot study is to assess the ability of magnetic resonance imaging with a new intravenous contrast agent (Combidex) to non-invasively detect inflammatory changes in the pancreas, specifically lymphocytic infiltration of the islets in individuals with either new onset type 1 diabetes or pre-type 1 diabetes (those with genetic risk for developing type 1 diabetes). The study includes blood work for markers of autoimmunity, diabetes, and glycemic control as well as 3 MRIs (baseline, one immediately after contrast, and a delayed scan).
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