PT  - JOURNAL ARTICLE
AU  - Al-Majdoub, Mahmoud
AU  - Ali, Arslan
AU  - Storm, Petter
AU  - Rosengren, Anders H.
AU  - Groop, Leif
AU  - Spégel, Peter
TI  - Metabolite Profiling of LADA Challenges the View of a Metabolically Distinct Subtype
AID  - 10.2337/db16-0779
DP  - 2017 Apr 01
TA  - Diabetes
PG  - 806--814
VI  - 66
IP  - 4
4099  - http://diabetes.diabetesjournals.org/content/66/4/806.short
4100  - http://diabetes.diabetesjournals.org/content/66/4/806.full
SO  - Diabetes2017 Apr 01; 66
AB  - Latent autoimmune diabetes in adults (LADA) usually refers to GAD65 autoantibodies (GADAb)–positive diabetes with onset after 35 years of age and no insulin treatment within the first 6 months after diagnosis. However, it is not always easy to distinguish LADA from type 1 or type 2 diabetes. In this study, we examined whether metabolite profiling could help to distinguish LADA (n = 50) from type 1 diabetes (n = 50) and type 2 diabetes (n = 50). Of 123 identified metabolites, 99 differed between the diabetes types. However, no unique metabolite profile could be identified for any of the types. Instead, the metabolome varied along a C-peptide–driven continuum from type 1 diabetes via LADA to type 2 diabetes. LADA was more similar to type 2 diabetes than to type 1 diabetes. In a principal component analysis, LADA patients overlapping with type 1 diabetes progressed faster to insulin therapy than those overlapping with type 2 diabetes. In conclusion, we could not find any unique metabolite profile distinguishing LADA from type 1 and type 2 diabetes. Rather, LADA was metabolically an intermediate of type 1 and type 2 diabetes, with those patients closer to the former showing a faster progression to insulin therapy than those closer to the latter.