In type 1 diabetes, the immune system begins to destroy insulin production. beta cells in the pancreas. Preserving or restoring beta cell mass is a central treatment goal, because the progressive loss of these cells destabilizes the body’s blood sugar levels and accelerates disease progression.
Although new treatments aimed at preserving or increasing beta cell mass are rapidly advancing, non-invasive, direct measurements of this mass, and how much is preserved or restored by intervention, are still lacking in routine clinical practice. Assessment of beta-cell loss primarily relies on indirect blood-based markers that can be influenced by glycemic status, making it difficult to assess as the condition progresses.
Taking this as an opportunity, the Kyoto University research team 18F-labeled PET tracer target GLP-1 receptorThey hypothesized that this could provide a non-invasive assessment of residual beta cell mass.
Our study was driven by important gaps in type 1 diabetes research and care. We hope this approach will help fill that gap by providing objective information for treatment evaluation. ”
Kentaro Sakaki, lead author and research assistant, Kyoto University
The research team conducted a prospective study at Kyoto University Hospital, starting with intravenous administration. (18F)FB(ePEG12)12-exendin-4is a PET tracer that targets the GLP-1 receptor and was administered to adults with type 1 diabetes who subsequently underwent PET and CT imaging. The researchers then quantified pancreatic uptake using standardized PET measurements and compared it to data from participants without diabetes. Finally, the team examined the imaging results in relation to clinical and laboratory measurements related to beta cell function and glucose levels.
As a result, patients with type 1 diabetes had lower pancreatic imaging measurements than non-diabetic participants; Hemoglobin A1caverage blood glucose measurements over the past 2 to 3 months, and total daily insulin doses used for treatment. The researchers also observed no serious side effects in the participants.
Larger, longer-term studies, and studies with more diverse participants are needed to confirm the utility of PET tracers in measuring beta-cell mass. However, if demonstrated in future studies, beta cell-targeted PET/CT may complement existing assessments with direct image-based readout of residual beta cell mass.
This method could be useful in defining disease stages, tracking changes over time, and providing objective endpoints for clinical studies aimed at preserving or restoring beta cells. This may be particularly useful when beta cell function is temporarily reduced and does not reflect residual beta cell mass.
“Many decisions in the treatment of type 1 diabetes benefit from a clearer understanding of how much beta cell mass remains,” says team leader Takaaki Murakami. “Our findings suggest that this tracer has the potential to provide non-invasive, quantitative information to support disease staging and treatment monitoring.”
sauce:
Reference magazines:
Sakaki, K., Others. (2026). Quantitative β-cell mass imaging redefines disease staging and glycemic control in type 1 diabetes. diabetes. DOI: 10.2337/db25-1127. https://diabetesjournals.org/diabetes/article/doi/10.2337/db25-1127/164564/Quantitative-Cell-Mass-Imaging-Redefines-Disease.
