Son's GAD test results - Page 5

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Son's GAD test results - Page 5


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Old 08-22-2018, 19:04   #41
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Did they get C-peptide tests back? This test is important

Your son likely is not showing symptoms of type 1 or 1.5 LADA yet because he still has sufficient level of islet cell/beta cell production of insulin but that level of islets could be under attack and in time may drop to say under 150,000 islets requiring insulin.

Why didnt they do a panel of autoantibodies which includes following

GAD65 negative
looks for antibodies built against a specific enzyme in the pancreatic beta cells that produce insulin.

IAA
This tests looks for the antibodies targeting insulin.

IA-2A
Tests for antibodies against specific enzyme in beta cells. Both the IA-2A and GADA tests are common type 1 antibody tests performed by Drs

ZNT8A - positive
This is one of the newest type 1 tests and looks at antibodies targeting an enzyme that is specific to beta cells. Can be predictive of T1D in combination with GAD

If all other auto antibody tests come back negative, and c peptide adaquate, then he may be just more inclined to become a type 1 or LADA but may not develop type 1

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8 grandmal seizures requiring paramedics + ER
Dx heart disease in 2000; triple bypass surgery
2 pancreas organ transplants 2001+2004 at Univ Minn & Univ Calif San Francisco med ctr
Dx with cancer twice 2007 & 2008, stage 2 & 3
Lost 2 transplanted pancreas; 6/2001 & 6/2015
Longtime advocate & member of diabetes & cancer support forums for 15 yrs. A1c 5.0

Last edited by Hearts Jounrey; 08-22-2018 at 19:13.
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Old 08-22-2018, 19:41   #42
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The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 1, 1 January 2010, Pages 25–33, https://doi.org/10.1210/jc.2009-1365

Quote:
How can risk be assessed?
Prospective studies in relatives of patients with type 1 diabetes have shown that development of multiple islet autoantibodies is a critical step in pathogenesis and that this provides a robust and early marker of risk of progression to diabetes. It has been known for more than a decade that detection of two or more islet autoantibodies is associated with a much higher risk of type 1 diabetes than a single autoantibody (25–28). This observation was confirmed in the large prevention trials, the European Nicotinamide Diabetes Intervention Trial (ENDIT) (29) and the Diabetes Prevention Trial-Type 1 (DPT-1) (30). In ENDIT, baseline samples from all participants were tested for ICA, IAA, GADA, and IA-2A. Those with ICA alone had a 2.2% cumulative risk of diabetes within 5 yr, whereas the risks with one, two, or three additional antibodies were 17, 39, and 70%, respectively. Multiple antibodies are not only specific but also sensitive; 91% of the ENDIT relatives who progressed to diabetes had two or three markers in addition to ICA. This message is strikingly consistent between studies, irrespective of the autoantibodies tested, although those using only GADA, IA-2A, and IAA and omitting ICA have generally found higher rates of progression in single antibody-positive relatives (26, 27). Additional testing for the recently described ZnT8A, however, reclassifies some relatives previously “single antibody positive” as “multiple antibody positive” and is associated with increased risk, thus bringing results into closer alignment with other studies (11, 31).

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Diagnosed with Type 1 diabetes Sept 12 1977
Developed Hypoglycemic Unawareness Dec 83
8 grandmal seizures requiring paramedics + ER
Dx heart disease in 2000; triple bypass surgery
2 pancreas organ transplants 2001+2004 at Univ Minn & Univ Calif San Francisco med ctr
Dx with cancer twice 2007 & 2008, stage 2 & 3
Lost 2 transplanted pancreas; 6/2001 & 6/2015
Longtime advocate & member of diabetes & cancer support forums for 15 yrs. A1c 5.0
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Old 08-22-2018, 21:34   #43
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Sorry his results were

GAD test ?..negative
1A2 test (need of insulin) ...negative
ZnT8 ....positive

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Old 08-22-2018, 22:15   #44
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Quote:
Originally Posted by Hearts Jounrey View Post
Im posting here as well to Lilly's feedback on tests for son

Did they get C-peptide tests back? This test is important

Your son likely is not showing symptoms of type 1 or 1.5 LADA yet because he still has sufficient level of islet cell/beta cell production of insulin but that level of islets could be under attack and in time may drop to say under 150,000 islets requiring insulin.

Why didnt they do a panel of autoantibodies which includes following

GAD65 negative
looks for antibodies built against a specific enzyme in the pancreatic beta cells that produce insulin.

IAA
This tests looks for the antibodies targeting insulin.

IA-2A
Tests for antibodies against specific enzyme in beta cells. Both the IA-2A and GADA tests are common type 1 antibody tests performed by Drs

ZNT8A - positive
This is one of the newest type 1 tests and looks at antibodies targeting an enzyme that is specific to beta cells. Can be predictive of T1D in combination with GAD

If all other auto antibody tests come back negative, and c peptide adaquate, then he may be just more inclined to become a type 1 or LADA but may not develop type 1

Hi Hearts Jounrey
C peptide test done back in May which was ...Negative
GAD test ...negative
1A-2 test ...negative
ZnT8 test ...positive

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Old 08-22-2018, 22:18   #45
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c peptide should have a value something like 0.5 thru 3.5. or a range of what is normal.

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Diagnosed with Type 1 diabetes Sept 12 1977
Developed Hypoglycemic Unawareness Dec 83
8 grandmal seizures requiring paramedics + ER
Dx heart disease in 2000; triple bypass surgery
2 pancreas organ transplants 2001+2004 at Univ Minn & Univ Calif San Francisco med ctr
Dx with cancer twice 2007 & 2008, stage 2 & 3
Lost 2 transplanted pancreas; 6/2001 & 6/2015
Longtime advocate & member of diabetes & cancer support forums for 15 yrs. A1c 5.0
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Old 08-22-2018, 22:31   #46
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Quote:
Originally Posted by Hearts Jounrey View Post
c peptide should have a value something like 0.5 thru 3.5. or a range of what is normal.

I've just text him about this, he said he can't really remember back in May that much only that it was normal his CPeptide test
He said when he goes back to see them (he is awaiting an appointment) he will ask them the exact result

The information above, I don't quite understand it, what is it actually
stating that he is type one ???

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Old 08-22-2018, 22:51   #47
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The only auto antibody test i didnt see run was IAA which targets insulin. The GAD and IA-2 tests were negative and his C -peptide was normal last May. If your son had a c peptide value of 0.0 to say 0.5 that would be red flag as it would mean no or only trace levels of insulin is being produced by beta cells.

I would hope he monitors his blood sugar levels periodically as well as his A1c. He should ask Dr how often he should get his A!C, autoantibodies and C-peptide tests done as well. Now that he has a baseline done with his recent tests, you have something to compare to in future.

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Diagnosed with Type 1 diabetes Sept 12 1977
Developed Hypoglycemic Unawareness Dec 83
8 grandmal seizures requiring paramedics + ER
Dx heart disease in 2000; triple bypass surgery
2 pancreas organ transplants 2001+2004 at Univ Minn & Univ Calif San Francisco med ctr
Dx with cancer twice 2007 & 2008, stage 2 & 3
Lost 2 transplanted pancreas; 6/2001 & 6/2015
Longtime advocate & member of diabetes & cancer support forums for 15 yrs. A1c 5.0
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Old 08-22-2018, 22:56   #48
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Lily, it helps to understand the difference between typical T1 and LADA. This article on www.bloodsugar101.com explains it well, I think.
Diabetes Update: The LADA Epidemic. What's Going on Here?

Quote:
... LADA is really a slow-developing form of Type 1. The body mounts an immune attack on the pancreas and wipes out the insulin producing cells. The difference between LADA and classic Type 1 is the speed with which this happens. In young Type 1s a person can go from normal to completely whacked in a week. People with LADA may take up to a decade to lose all their insulin-secreting capacity.
From past posts of members who have LADA, I have seen that it can be a roller coaster for a while during the time the pancreas performs off and on. This is called the honeymoon period.

According to what I've read, your son could have a long honeymoon period where his BG are normal, with intermittent periods of needing insulin. Time will tell how it goes for him. One good thing is that this first episode didn't last long and he now has some time to get used to his new body and develop strategies for his future.

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Old 08-23-2018, 03:29   #49
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I'm in learning mode here, so pardon what may be obviously off the wall questions. Is there a possibility that there was something chemical/neurological that temporarily disrupted the signaling of the release of glucagon or insulin causing high BG for a couple of days? Does the one positive either confirm the possibility or disprove the possibility of something other than Type 1, or is it only an indication of percentage of chance it could be Type 1?

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Old 08-23-2018, 04:23   #50
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The latter - only an indication of percentage of chance it could be Type 1?

Sometimes people are not sensitive to a particular auto antibody. I would say if this develops into a diabetic type, it would be LADA and not type 1 but this may not turn into diabetes at all though there could be some impaired beta cell function

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Diagnosed with Type 1 diabetes Sept 12 1977
Developed Hypoglycemic Unawareness Dec 83
8 grandmal seizures requiring paramedics + ER
Dx heart disease in 2000; triple bypass surgery
2 pancreas organ transplants 2001+2004 at Univ Minn & Univ Calif San Francisco med ctr
Dx with cancer twice 2007 & 2008, stage 2 & 3
Lost 2 transplanted pancreas; 6/2001 & 6/2015
Longtime advocate & member of diabetes & cancer support forums for 15 yrs. A1c 5.0
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