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dc.contributor.authorHals, Ingrid Kathrin
dc.contributor.authorFleiner, Hanne Fiskvik
dc.contributor.authorReimers, Nina
dc.contributor.authorAstor, Marianne
dc.contributor.authorFilipsson, Karin
dc.contributor.authorMa, Zuheng
dc.contributor.authorGrill, Valdemar Erik Robert
dc.contributor.authorBjörklund, Anneli
dc.date.accessioned2020-04-27T10:52:54Z
dc.date.available2020-04-27T10:52:54Z
dc.date.created2019-09-15T11:55:17Z
dc.date.issued2019
dc.identifier.citationDiabetes, obesity and metabolism. 2019, 21 (10), 2219-2227.en_US
dc.identifier.issn1462-8902
dc.identifier.urihttps://hdl.handle.net/11250/2652611
dc.description.abstractAims To compare outcomes of glucagon‐stimulated C‐peptide tests (GSCTs) in people with latent autoimmune diabetes in adults (LADA) after a 21‐month intervention with either insulin or the dipeptidyl peptidase‐4 inhibitor sitagliptin. Research design and methods We included 64 glutamic acid decarboxylase (GAD) antibody‐positive individuals, who were diagnosed with diabetes <3 years before the study, aged 30 to 70 years, and without clinical need for insulin treatment. We stratified participants by age and body mass index (BMI) and evaluated β‐cell function by GSCT after a 48‐hour temporary withdrawal of study medication. Results Age at randomization (mean 53 years), BMI (mean 27 kg/m2) and metabolic markers were similar between treatment arms. Glycated haemoglobin concentrations during intervention did not differ between arms. Fasting C‐peptide concentrations after the intervention were similar, as were stimulated C‐peptide levels (0.82 ± 0.63 nmol/L after insulin, 0.82 ± 0.46 nmol/L after sitagliptin; nonsignificant). Autoimmunity in the study population (estimated from GAD antibody titres and positivity/no positivity for zinc transporter 8 and islet antigen 2 antibodies) affected the evolution of the GSCT results significantly, which deteriorated in participants with high but not in those with low autoimmunity. Adjustment using analysis of covariance for the degree of autoimmunity did not alter the findings of no difference between treatment arms. Conclusions β‐cell function after intervention was similar in patients with insulin‐ and sitagliptin‐treated LADA, regardless of the strength of autoimmunity. Further, participants with low levels of GAD antibodies did not experience progressive deterioration of β‐cell function over a 21‐month period. Taken together, these findings could be useful for clinicians' choices of treatment in people with LADA.en_US
dc.language.isoengen_US
dc.publisherWileyen_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/deed.no*
dc.titleInvestigating optimal β-cell-preserving treatment in latent autoimmune diabetes in adults: Results from a 21-month randomized trialen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.source.pagenumber2219-2227en_US
dc.source.volume21en_US
dc.source.journalDiabetes, obesity and metabolismen_US
dc.source.issue10en_US
dc.identifier.doi10.1111/dom.13797
dc.identifier.cristin1724777
dc.description.localcode© 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.en_US
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cristin.fulltextoriginal
cristin.qualitycode1


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