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The Relationship of Insulin Secretion and GAD65 Antibody Levels at Diagnosis on Glycemic Control in Type 2 Diabetes

ABSTRACT Objective: To determine if pretreatment insulin and C-peptide levels together with antibody status are predictive of HbA1c 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 HbA1c 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 HbA1c level.