Aim. To evaluate changes in functional activity and insulin resistance (IR) in patients with different types of onset of diabetes mellitus (DM). Materials and methods. We examined 166 subjects which were subdivided into 4 study groups and 1 control group. Assessment of total -cell functional activity and degree of IR (according to HOMA-model) was conducted in patients with different variants of DM onset and in the group of high risk for type 1 DM. Results. The most significant decrease in -cell functional activity was found in patients with type 1 diabetes mellitus (HOMA-F 8.9%). Onset of LADA (Latent autoimmune diabetes in adults) and type 2 diabetes mellitus (T2DM) was also characterized by decrease in -cell functional activity (HOMA-F 39.2% and 63.9%, respectively), as well as by development of IR: HOMA-IR 3.7 and 7.2, respectively. Conclusion. Clinical onset of LADA and T2DM occurs against the background of decreased -cell functional activity and compromised peripheral insulin sensitivity.