The Exocrine Pancreas Emerges as a Critical Player in Diabetes Pathophysiology and Care
核心洞察
Growing evidence indicates the exocrine pancreas plays a critical role in diabetes (搜索) pathophysiology, extending beyond the traditional endocrine-focused view of the disease.
Structural, functional, and inflammatory alterations of the exocrine pancreas have been observed across type 1, type 2, and pancreatogenic (type 3c) diabetes (搜索), including cystic fibrosis-related diabetes (搜索).
A complex bidirectional relationship exists in which diabetes (搜索) itself can contribute to exocrine pancreatic dysfunction, with important implications for diagnosis, nutritional status, and patient care.
Diabetes (搜索) has traditionally been viewed as a disorder of the endocrine pancreas, characterized by impaired insulin action and dysregulated glucose homeostasis. However, growing evidence indicates that the exocrine pancreas also plays a critical role in diabetes pathophysiology, a perspective that carries important implications for disease progression, diagnosis, nutritional status, and patient care.
Structural, functional, and inflammatory alterations of the exocrine pancreas have been observed across the spectrum of diabetes (搜索), including type 1 diabetes (搜索), type 2 diabetes (搜索), pancreatogenic (type 3c) diabetes (搜索) including cystic fibrosis-related diabetes (搜索), and monogenic forms of the disease. Conversely, diabetes itself can contribute to exocrine pancreatic dysfunction, creating a complex bidirectional relationship that remains poorly understood and underappreciated in both research and clinical practice.
The Endocrine-Exocrine Axis in Diabetes
Despite increasing recognition of the endocrine-exocrine axis, many aspects of this interaction remain incompletely characterized. The emerging evidence challenges the long-standing assumption that diabetes (搜索) is exclusively an endocrine disorder, instead positioning the exocrine pancreas as an integral component of disease pathophysiology.
The bidirectional nature of this relationship is a central theme: exocrine pancreatic dysfunction may contribute to the development and progression of diabetes (搜索), while diabetes itself can drive structural and functional changes in the exocrine pancreas. This interplay has significant consequences for how clinicians approach disease classification, diagnosis, and management.
A New Research Agenda
To advance understanding of the role of the exocrine pancreas in diabetes (搜索) pathophysiology and care, Frontiers (搜索) has launched a Research Topic welcoming multidisciplinary contributions spanning basic, translational, and clinical research. The initiative aims to investigate the mechanisms linking exocrine pancreatic dysfunction with diabetes development, progression, complications, and treatment.
Particular emphasis will be placed on studies that improve disease classification, identify novel biomarkers, clarify endocrine-exocrine interactions, and inform more comprehensive approaches to diabetes (搜索) diagnosis and management.
Key Areas of Investigation
The Research Topic outlines several priority themes, including endocrine-exocrine crosstalk in diabetes (搜索) pathophysiology; exocrine pancreatic dysfunction in type 1, type 2, and pancreatogenic (type 3c) diabetes (搜索); and mechanisms linking pancreatic inflammation, fibrosis, and diabetes.
Additional areas of focus include pancreatic enzyme insufficiency and its impact on glycemic control, nutrition, and metabolic health; imaging, histopathology, and functional assessment of the exocrine pancreas in diabetes (搜索); and biomarkers of exocrine pancreatic dysfunction and their diagnostic or prognostic value.
The collection also addresses pancreatic diseases, including pancreatitis (搜索) and pancreatic cancer (搜索), in relation to diabetes (搜索); cystic fibrosis-related diabetes (搜索) and other disorders involving combined endocrine and exocrine dysfunction; therapeutic strategies targeting exocrine pancreatic disease and their effects on diabetes outcomes; and precision medicine approaches integrating endocrine and exocrine pancreatic assessment into diabetes care.
Toward Integrated Diabetes Care
This collection seeks to highlight the growing importance of the exocrine pancreas in diabetes (搜索) research and to encourage new perspectives on the mechanisms, diagnosis, and clinical management of diabetes through a more integrated understanding of pancreatic biology. By bridging endocrine and exocrine perspectives, the initiative aims to support more comprehensive and patient-centered approaches to diabetes care.