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.