Introduction
adult-onset autoimmune type 1 diabetes, hypoglycaemia, LADA, diabetes
TYPE 1 DIABETES, TYPE 2 DIABETES, AUTOIMMUNE, HYPOGLYCAEMIA
Autoimmune type 1 diabetes, mediated through immune perturbations, is charactered by progressive destruction of β-cells, and eventually a lifelong dependence on insulin therapy.So-called LADA, the most common subtype of adult-onset type 1 diabetes, affects around 10 million people in China, and it has been estimated that the incidence is gradually increasing worldwide.One such incretin agonist is a dipeptidyl peptidase 4 (DPP-4) inhibitor, such as saxagliptin, first approved by the US Food and Drug Administration, and now widely used in over 66 countries including China as an oral hypoglycaemia agent for type 2 diabetes. In a preliminary study, we showed the potential benefit of a DPP-4 inhibitor as an adjunct to insulin therapy.To this end, we conducted a multi-centre, randomized, controlled trial with large sample size sufficiently powered to examine whether a DPP-4 inhibitor (saxagliptin) with or without vitamin D as an adjunct to conventional therapy would preserve β-cell function and enhance clinical measures in patients with adult-onset autoimmune type 1 diabetes.