Background <p>Shear Wave elastography (SWE) is a non-invasive tool that measures the degree of tissue stiffness in organs such as the thyroid, liver and breast. There are few studies evaluating the usefulness of shear wave elastography of the pancreas. And even fewer studies discussing its applicability in Type&#xa0;2 Diabetes Mellitus patients.</p> Aim of the work <p> To assess the utility of pancreatic B-mode ultrasonography and shear wave elastography in characterizing the morphological and mechanical alterations in the pancreatic parenchyma of adults with Type 2 Diabetes Mellitus (T2DM) compared to non-diabetic controls, with a secondary focus on the impact of disease duration and glycemic control.</p> Methods <p>We conducted a prospective case–control study involving ultrasound examination to evaluate morphological and&#xa0;mechanical&#xa0;changes of the&#xa0;pancreatic tissue between 17 laboratory proven adults with T2DM and&#xa0;17 age matched controls. Initially, the pancreas was assessed using B-mode imaging. Following this, two-dimensional shear wave elastography was performed using elastography display mode.</p> Results <p>A statistically significant difference in shear wave elastography values was found between the two groups, with cases showing faster shear wave elastography values 10.54 ± 2.04 kilopascals (kPa) compared to controls 8.63 ± 1.08 kPa (p = 0.002). Among the cases, a strong positive correlation was observed between SWE values and Glycated Hemoglobin A1c (Hb A1c) (<i>r</i> = 0.629,&#xa0;<i>p</i> = 0.007) with higher Hb A1c values associated with faster shear wave elastography readings. Additionally, SWE values were positively correlated with duration of diabetes, with longer disease durations being associated with higher SWE values (<i>r</i> = 0.58, <i>p</i> = 0.015).</p> Conclusion <p>Shear wave elastography holds promise as a noninvasive imaging technique for the monitoring of disease progression in T2DM adult patients.</p>