INS and type 1 diabetes mellitus: Classically described as a disease affecting the beta cells, type 1 diabetes has recently been recognized to involve the entire pancreas1 with reports of reduced pancreas volume2–8 and exocrine dysfunction.9–14 It has been proposed that beta-cell loss in type 1 diabetes is responsible for the reduced pancreas size and function of acinar tissue due to loss of trophic effects exerted by insulin.15 However, others debate that exocrine damage precedes type 1 diabetes onset,10 16 suggesting that acinar volume/function loss is caused by other factors than an indirect effect of beta-cell loss.