Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients

Harvey K. Chiu, Elaine C. Tsai, Rattan Juneja, James Stoever, Barbara Brooks-Worrell, Amit Goel, Jerry P. Palmer

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Insulin resistance is a primary component in the pathophysiology of type 2 diabetes. In latent autoimmune diabetes in adults (LADA), insulin resistance has been reported to be significantly lower than in autoantibody-negative type 2 diabetes (T2DM), but whether this might be related to differences in body mass index (BMI) has not been excluded. Furthermore, previous studies have used limiting inclusive criteria for LADA, requiring only the presence of GADA or IA-2A. To apply more inclusive criteria for LADA, consistent with recent recommendations, we defined LADA by clinical manifestations characteristic of T2DM, but with the presence of any combination of GADA, IA-2A, ICA, or IAA. We recruited 43 LADA patients, 70 T2DM patients, and 150 non-diabetic controls. Insulin resistance was assessed by both the homeostasis model assessment and the quantitative insulin sensitivity check index, and BMI was calculated. We found that insulin resistance in LADA is equivalent to that of T2DM. When insulin resistance is assessed as a function of BMI, both diabetic populations demonstrated an insulin resistance equally greater than normal controls. The interaction between insulin resistance and BMI in the two diabetic groups was significantly different from that demonstrated in non-diabetic controls. In summary, LADA demonstrates insulin resistance of similar magnitude to T2DM, but with the concurrent component of an immune attack against the pancreatic beta-cells. LADA patients may be at significant risk for metabolic consequences of insulin resistance other than glucose metabolism, such as those described in the metabolic syndrome. As complications and treatment regimens specific to LADA are realized, improved means of identification of LADA will become increasingly important.

Original languageEnglish (US)
Pages (from-to)237-244
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume77
Issue number2
DOIs
StatePublished - Aug 1 2007
Externally publishedYes

Keywords

  • Body mass index (BMI)
  • Homeostasis model assessment (HOMA)
  • Insulin resistance
  • Latent autoimmune diabetes in adults (LADA)
  • Pancreatic autoantibody

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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