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.

Supporting Information

Filename	Description
dme12434-sup-0001-TableS1-S2.pdfPDF document, 35.5 KB	Table S1. Subject characteristics Table S2. Results of time-series analysis of insulin concentration time series at baseline and during glucose-entrained conditions
dme12434-sup-0002-FigS1.pdfPDF document, 96 KB	Figure S1. Insulin concentration after i.v. glucose injection. In all three groups, a severely blunted first-phase insulin secretion response was seen, as opposed to the immediate rise seen in healthy individuals. People with Type 2 diabetes had a significantly higher area under the curve, which may be attributable to the apparent hyperinsulinemia at the start of the test.
dme12434-sup-0003-FigS2.pdfPDF document, 97.5 KB	Figure S2. The time course of s-paracetamol during the meal-test. Area under the curve (0–240 min) did not differ among the groups. Although the figure may indicate that absorption was faster in the group without LADA and with Type 2 diabetes, the time at which half of the paracetamol was absorbed did not differ significantly.
dme12434-sup-0004-FigS3.pdfPDF document, 94.7 KB	Figure S3. Insulin secretion measured as the area under the curve after i.v. glucose infusion plotted against insulin sensitivity as measured by the glucose infusion rate during the euglycemic-hyperinsulinemic clamp procedure showed a hyperbolic relationship. The people with LADA did not cluster in the plot, indicating that the LADA diagnosis per se is not characterized by a specific defect in insulin secretion or insulin sensitivity.

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Similar weight-adjusted insulin secretion and insulin sensitivity in short-duration late autoimmune diabetes of adulthood (LADA) and Type 2 diabetes: Action LADA 8

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Similar weight-adjusted insulin secretion and insulin sensitivity in short-duration late autoimmune diabetes of adulthood (LADA) and Type 2 diabetes: Action LADA 8

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