The relationship of insulin secretion and GAD65 antibody levels at diagnosis on glycemic control in type 2 diabetes.

OBJECTIVE: To determine if pretreatment insulin and C-peptide levels together with antibody status are predictive of HbAlc levels before and during therapy in obese African-American youth with type 2 diabetes. METHODS: Records of African-American patients with clinical diagnosis of type 2 diabetes were retrospectively analyzed. Insulin, C-peptide, blood glucose, HbA1c and islet autoantibodies at diagnosis were recorded. These variables were compared with HbA1c levels during therapy. RESULTS: Eight of 45 patients were islet autoantibody positive. There was no difference in age, Body Mass Index z-score, insulin, C-peptide, glucose or HbAlc levels between antibody positive or negative patients. Insulin (r = -0.45, p < 0.01 n=45) and C-peptide (r = -0.59, p < 0.001, n=36) were correlated with HbA1c at diagnosis but not during therapy. CONCLUSIONS: Higher insulin levels were associated with lower HbA1c at presentation but not during therapy. Antibody status was not associated with differences in insulin, C-peptide levels or HbAlc level.

Duke Scholars

Author Pinar Gumus Balikcioglu Pediatrics, Endocrinology