Intervention to Preserve Beta-Cell Function in GAD Ab-Positive Diabetes
Intervention to Preserve Beta-Cell Function in GAD Ab-Positive Diabetes
We tested the hypothesis that insulin therapy rather than sulfonylurea (SU) treatment has a
 preferable outcome to reverse or preserve beta cell function in the patients with diabetes
 that is called slowly progressive insulin-dependent (type 1) diabetes (SPIDDM) or latent
 autoimmune diabetes in adult (LADA).
In a multicenter, randomized, nonblinded clinical study, 4,089 non-insulin dependent diabetic
 patients were screened for glutamic acid decarboxylase autoantibodies (GADAb). Sixty
 GADAb-positive non-insulin requiring diabetic patients with duration of diabetes =/<5 years
 were assigned to either the SU group (n = 30) or the Insulin group (n = 30). Serum C-peptide
 response to annual oral glucose tolerance tests were followed for 57 mean months. The primary
 endpoint was insulin-dependency (IDDM: integrated C-peptide values [sigma C-peptide] <4
 ng/ml).
Inclusion Criteria:

 -  Subjects should use SU agents to obtain as a goal good glycemic control.

 -  Duration of diabetes within 5 years from the onset (or diagnosis).

 Exclusion Criteria:

 -  Subjects having history of hyperglycemia requiring insulin treatment and/or history of
 ketosis/ketoacidosis were excluded.

 -  Subjects with malignant diseases, systemic inflammatory diseases, renal or liver
 disorders or malabsorption were also excluded.