Insulin and Glucagon Secretion in Patients with Slowly Progressing Autoimmune Diabetes (LADA)

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Abstract
To metabolically characterize patients with slowly progressing au- toimmune diabetes (LADA) of short duration we measured insulin, C peptide, and glucagon responses to glucose and arginine at three blood glucose levels (fasting and 14 and 28 mmol/L) in 11 patients with LADA, 11 patients with type 2 diabetes, and 14 healthy control sub- jects matched for age and body mass index. The acute insulin response to arginine was impaired in LADA vs. type 2 diabetes at all glucose levels, with the greatest impairment in the maximally stimulated insulin concentrations (P , 0.04). In contrast, b-cell sensitivity to glucose was unaltered in LADA and type 2 diabetes. The glucagon concentrations were elevated in both LADA and type 2 diabetic pa- tients compared with healthy control subjects (P , 0.02), but did not differ between the diabetic groups. In conclusion, patients with LADA share insulin resistance with type 2 diabetic patients, but display a more severe defect in maximally stimulated b-cell capacity than pa- tients with type 2 diabetes. (J Clin Endocrinol Metab 85: 76 - 80, 2000)

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