Similar weight-adjusted insulin secretion and insulin sensitivity in short-duration late autoimmune diabetes of adulthood (LADA) and type 2 diabetes: Action LADA 9 [corrected]

Diabet Med. 2014 Aug;31(8):941-5. doi: 10.1111/dme.12434. Epub 2014 Apr 9.

Abstract

Aims: To explore insulin sensitivity and insulin secretion in people with latent autoimmune diabetes in adulthood (LADA) compared with that in people with type 2 diabetes.

Methods: A total of 12 people with LADA, defined as glutamic acid decarboxylase (GAD) antibody positivity and > 1 year of insulin independency (group A) were age-matched pairwise to people with type 2 diabetes (group B) and to six people with type 2 diabetes of similar age and BMI (group C). β-Cell function (first-phase insulin secretion and assessment of insulin pulsatility), insulin sensitivity (hyperinsulinemic-euglycemic clamp) and metabolic response during a mixed meal were studied.

Results: Both first-phase insulin secretion and insulin release during the meal were greater (P = 0.05 and P = 0.009, respectively) in type 2 diabetes as compared with LADA; these differences were lost on adjustment for BMI (group C) and could be explained by BMI alone in a multivariate analysis. Neither insulin pulsatility, incretin secretion nor insulin sensitivity differed among the groups.

Conclusions: We found no evidence that LADA and type 2 diabetes were distinct disease entities beyond the differences explained by BMI.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Autoantibodies / analysis
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / epidemiology
  • Autoimmune Diseases / metabolism*
  • Blood Glucose / analysis
  • Body Mass Index
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism*
  • Glucose Clamp Technique
  • Glutamate Decarboxylase / antagonists & inhibitors
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Incretins / blood
  • Incretins / metabolism
  • Insulin / blood
  • Insulin / metabolism*
  • Insulin / therapeutic use
  • Insulin Resistance*
  • Insulin Secretion
  • Insulin-Secreting Cells / drug effects
  • Insulin-Secreting Cells / metabolism*
  • Matched-Pair Analysis
  • Obesity / complications
  • Overweight / complications
  • Postprandial Period

Substances

  • Autoantibodies
  • Blood Glucose
  • Hypoglycemic Agents
  • Incretins
  • Insulin
  • Glutamate Decarboxylase