What causes fatty pancreas?
The main cause of a fatty pancreas is excess energy intake and obesity (1). There are also genetic factors that contribute excess pancreatic fat storage.
Fat can be safely stored under the skin, this is called subcutaneous fat. However, if the fat cells under the skin do not have the genes to expand then fat storage at this location will be limited (2).
Larger amounts of excess fat is then stored in parts of the body such as the liver, heart, muscle and pancreas (2). Excess fat storage in organs is known to negatively affect the function of these organs.
How does fat affect insulin release?
Type 2 diabetics also have a greater amount of fat content in the pancreas compared to people without diabetes (3). High pancreatic fat storage in the pancreas is associated with a lack of insulin response to carbohydrate intake (4).
The increased in fat storage may cause greater fat oxidation, which increases oxidative stress in the pancreas (5). Oxidative stress may alter the gene expression of insulin and therefore less insulin is produced and released (6).
Does getting fat mean I will become diabetic?
There is a strong link between obesity and type 2 diabetes. However, obesity does not guarantee type 2 diabetes. There are a number of other risk factors aside from obesity.
As previously mentioned, the location of excess fat is an important factor excess fat can be stored in various organs (known as ectopic fat). A large waist circumference is an indicator of high levels of ectopic fat. A large waist circumference is a stronger predictor of type 2 diabetes than BMI.
Genetics and family history
People with a genetic predisposition to type II diabetes, that also become obese, are at the greatest risk of type 2 diabetes. If you have a family history of type 2 diabetes than you are at a greater risk. Having a parent with type 2 diabetes increases the risk by 4 times. Having both parents with type 2 diabetes can increase the risk by 6 times (7).
Type 2 diabetes is typically diagnosed above the age of 40. However, with the rapid increase in obesity has increased the number of young people being diagnosed with type 2 diabetes. (8).
People of different racial and ethnic groups are more likely to develop type 2 diabetes. African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders and Asian Americans have a higher risk.
Some ethnic groups may have a genetic predisposition to type 2 diabetes. However, other factors such as higher rates of obesity, lack of physical activity and less access to healthcare, may increase type 2 diabetes risk in these ethnic groups (8).
2 Ways To Burn Fat From Your Pancreas
Diet & lifestyle
Many studies have shown that beta-cell function can be improved through weight loss.
A study published in a journal called Diabetologia showed that after following a very low calorie diet for 8 weeks, there was a reduction in fat storage within the pancreas and pancreatic beta function returned to normal (9).
Another study looked at whether an intensive weight loss intervention could restore beta cell function in on newly diagnosed type 2 diabetics (Solomon 2010).
The participants underwent 3 months of an intensive weight loss program. At the end of the program the average weight loss was 5 kg. There was an increase in insulin release in the type 2 diabetic group, which indicates an improvement in beta cell function (10).
A randomised control trial compared the effects of diet and lifestyle combined with diabetic drugs to bariatric surgery. The participants underwent the treatments for two years. Despite similar weight loss, there was a greater improvement in beta cell function in the surgery group.
There was a greater reduction in abdominal fat in the surgery group, which may explain the superior improvements in beta cell function (11). A greater reduction in abdominal fat likely means a greater reduction in pancreatic fat storage.
A 5-year follow-up study compared medical treatment to weight loss surgery (12). The study found that weight loss surgery was much more effective at reversing type 2 diabetes. 50% of the surgical group remained in remission after 5 years.
None of the patients in the medical treatment group were able to reverse diabetes. There was no change in weight loss in the medical treatment group, which explains why this group were unable to reverse diabetes.
There were also a high number of diabetic complications in the medical therapy group, including one patient that diet from myocardial infarction (12).
Bariatric surgery seems to be the most effective way to reverse diabetes, particularly in obese type 2 diabetics. However, there are potential side effects and complications that can be caused by surgery.
Nutritional deficiencies, including protein-calorie malnutrition and deficiencies of iron, other minerals, and vitamins A, E, D, and B12, occur in 30% to 70% of patients. Severe nutrient deficiencies are common in very rapid weight loss (13).
Issues such as oedema and hair loss due to protein deficiency can also occur. If you suffer from this then increase protein intake through supplementation. There is a very low risk of death with bariatric surgery (> 1%).
However, patients that undergo a successful bariatric surgery have a lower death rate than those who did not undergo surgery (13).
- Mathur A, Marine M, Lu D, Swartz-Basile DA, Saxena R, Zyromski NJ, Pitt HA. Nonalcoholic fatty pancreas disease. Hpb. 2007 Aug 1;9(4):312-8.
- Amalia Gastaldelli & Melania Gaggini (2016) Ectopic fat: a target for cardiometabolic risk management, Expert Review of Cardiovascular Therapy, 14:12, 1301-1303
- Garcia TS, Rech TH, Leitão CB. Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies. PloS one. 2017 Jul 24;12(7):e0180911.
- White MG, Shaw JA, Taylor R. Type 2 diabetes: the pathologic basis of reversible β-cell dysfunction. Diabetes care. 2016 Nov 1;39(11):2080-8.
- Szendroedi J, Roden M. Ectopic lipids and organ function. Current opinion in lipidology. 2009 Feb 1;20(1):50-6.
- Hasnain SZ, Prins JB, McGuckin MA. Oxidative and endoplasmic reticulum stress in β-cell dysfunction in diabetes. Journal of Molecular Endocrinology. 2016 Feb 1;56(2):R33-54.
- Harrison TA, Hindorff LA, Kim H, Wines RC, Bowen DJ, McGrath BB, Edwards KL. Family history of diabetes as a potential public health tool. American journal of preventive medicine. 2003 Feb 28;24(2):152-9.
- Oldroyd J, Banerjee M, Heald A, Cruickshank K. Diabetes and ethnic minorities. Postgraduate medical journal. 2005 Aug 1;81(958):486-90.
- Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011 Oct 1;54(10):2506-14.
- Solomon TP, Haus JM, Kelly KR, Rocco M, Kashyap SR, Kirwan JP. Improved pancreatic beta-cell function in type 2 diabetics following lifestyle-induced weight loss is related to glucose-dependent insulinotropic polypeptide. Diabetes care. 2010 Feb 26.
- Kashyap SR, Bhatt DL, Wolski K, Watanabe RM, Abdul-Ghani M, Abood B, Pothier CE, Brethauer S, Nissen S, Gupta M, Kirwan JP. Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment. Diabetes care. 2013 Feb 15:DC_121596.
- Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F. Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet. 2015 Sep 5;386(9997):964-73.
- Kashyap SR, Gatmaitan P, Brethauer S, Schauer P. Bariatric surgery for type 2 diabetes: weighing the impact for obese patients. Cleveland Clinic journal of medicine. 2010 Jul;77(7):468.