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Son's GAD test results

13K views 73 replies 8 participants last post by  Lily B 
#1 · (Edited by Moderator)
[Moderator edit: This is a duplicate of the post that started the introductory thread Mother needing info.

Given the depth of discussion of testing to determine if Lily B's son has diabetes of any type, it was decided to move the bulk of the testing process discussion here so it can serve as a reference to other forum members who might find this information useful. The introductory thread will be locked; further discussion on this topic should continue here, and @Lily-B is encouraged to start other threads if she seeks additional information/support on diabetes-related topics beyond this diagnosis process.]

Hi I'm new to the forum, my son was diagnosed in April this year
With type 1, he is 30 and slim so he has been classed as type 1.
Son lives away from us so don't get to speak about it

He was unwell one day and mentioned it to his pal who is a doctor
he checked my sons BG it was 17 so he got him in hospital that morning
The hospital gave him a test which said he had small amount of ketones in his blood, because of his age and slim they gave him insulin to take once a day, 10units at bedtime, which by bedtime his BG was 12, then back to 5 the next morning thankfuly.
Within 3 days he was brought of insulin as is BG was to low they said.

Now his BG reading on waking is 3/4
1 1/2 after lunch it's 5.5
1 1/2 after dinner it's 6

He hasn't changed in the last 4 months
His specialist has done a GAD test on him we are awaiting results
she said his average 12weeks BG was normal readings!!

Do you think he could be type 1.5 or 2

Thanks in advance
 
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#2 · (Edited)
Determine if son has type 1 or type 1.5 first. GAD antibody test will help determine if he has LADA (1.5) diabetes. Results from one test should not be taken as a definitive diagnosis, instead two tests should be used to corroborate results.

Performing GADA antibody test is the most common method of diagnosing LADA but not all patients have these antibodies. In the very early stages of LADA, it is possible that there are no detectable antibodies, but they can develop over time. Therefore GADA test alone cannot rule out LADA.

LADA is distinguished from type 2 diabetes by the presence of islet autoantibodies that are common to type 1 diabetes.

Patients with type 1 diabetes commonly have 2 or more of 4 islet autoantibodies
these 4 include:

glutamic acid decarboxylase autoantibodies (GAD)
islet cell antigens (ICAs)
tyrosine phosphatase proteins (IA-2s)
Antibodies to (Insulin)

whereas patients with LADA typically only have one autoantibody. LADA patients have far less incidence of IA-2 and ICA autoantibodies than patients with type 1

Other testing for type 1.5 diabetes include having a "c-peptide" blood test to measure insulin production levels. This c-peptide biomarker is becoming more commonly used to distinguish T1.5 and T2. C-peptide is very low in people with T1D, low in people with T1.5 and normal in people with T2D.

In summary, i would have your son get all 4 of the antibody tests mentioned above highlighted in blue and a c-peptide test. If he has no auto-antibodies and his C peptide appear to be normal (fasting and after eating), then type 2 is likely but i would still follow up with periodic testing to see if anything has changed with his antibody or c -peptide levels
 
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#3 ·
I just wanted to translate Blood sugar values listed here from mmol/L to mg/dL that United States uses so its easier to know what value is for many of readers here. Basically multiply mmol value by 18

mmol/l = 5 mg/dl = 90
mmol/l = 6 mg/dl = 108
mmol/l = 12 mg/dl = 216
mmol/l = 17 mg/dl = 305

Hi I'm new to the forum, my son was diagnosed in April this year
With type 1, he is 30 and slim so he has been classed as type 1.
Son lives away from us so don't get to speak about it

He was unwell one day and mentioned it to his pal who is a doctor
he checked my sons BG it was 17 so he got him in hospital that morning
The hospital gave him a test which said he had small amount of ketones in his blood, because of his age and slim they gave him insulin to take once a day, 10units at bedtime, which by bedtime his BG was 12, then back to 5 the next morning thankfuly.
Within 3 days he was brought of insulin as is BG was to low they said.

Now his BG reading on waking is 3/4
1 1/2 after lunch it's 5.5
1 1/2 after dinner it's 6

He hasn't changed in the last 4 months
His specialist has done a GAD test on him we are awaiting results
she said his average 12weeks BG was normal readings!!

Do you think he could be type 1.5 or 2

Thanks in advance
 
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#4 ·
A person with Type 1.5 can be on again, off again early on with insulin production, which may explain being taken off insulin. We have had some Type 2's here on the forum that were diagnosed after going to the ER and finding out they were in DKA, but ended up still being type 2. I am type 2, but I would follow Hearts Jounrey's advise and tell your son he should take the antibody tests.
 
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#6 ·
Thank you alamogirl pleased to be here.x

My Son had BS of 17 when his doctor tested him, when he got to the hospital they said he had low amount ketones in his blood, they stated because of this and his age 30 and slim they said they assumed he was type 1
Within 2 days his bloods were back to normal again, he has been on no insulin/meds his bloods have stayed normal the last 4 months
Honeymoon period had been mentioned, but with no insulin you can't keep your blood sugars normal
We are awaiting GAD test result back, the first one they messed the bloods up

I'm very so confused, just want tomno what the hell is going on 😔
 
#10 · (Edited)
Lilly i see your response above, thanks. Wonder why Dr's are not ordering C-peptide along with the other antibody tests to go along with GAD at one time so they can see the big picture and connect the pieces.

Me also HJ, Son said the doctor is waiting on the GAD test results and then doing a C peptide test, why not together I don't no
This is why I'm so confused as he is doing excellent by diet and excercise, Infact he just seems back to normal self
With normal BS readings everyday for last 4months! xx
 
#11 ·
My son has had a call from the specialist saying his second test has been messed up he has to go and have another blood test done for his GAD test
My son isn't happy, is last one he got back in May said the same...
He is having another test done on Monday, how can they mess two test up ��
Still having good readings 5 months on : fasting 4, 2 hours after breakfast 5, then 2 hrs after lunch 5 and dinner 6 ...even with honeymoon with no insulin these readings are better then mine and his dads
 
#12 ·
excellent news on his fasting and after meals glucose readings. did he get his C-peptide test done or are Dr's waiting for GAD results? I would ask that GAD sample be sent to another lab facility so it can be processed correctly. Is your son on any type of meds for his glucose levels? I know you said he is not on insulin now.
 
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#13 ·
Was your son on Corticosteroids at some point especially when his glucose was high? If he had pancreatitis that would have elevated his blood sugars as well. If not, and he has been running normal glucose levels both fasting and post meal without any meds for an extended amount of time, that is all positive. I would still want to know if he has any auto-antibodies and what his C-peptide is.
 
#14 ·
Hearts Journey his doctor said it could be pancreatitis, no he wasn't on anything pre Spike of 17, he had eaten 5 Easter eggs on the Sunday and out with his pals drinking until 2 in the morning, then fell ill in the morning and his pal had him go to hospital it all happened really fast tbh

What do you mean all positive??? ��
 
#17 · (Edited)
Why do i use the word positive in post above? normal glucose readings and no meds over time. plus another condition could be cause of the high sugar levels he had

Since he is not on any type 2 drugs at this point and running normal glucose levels, I'm thinking those elevated levels of glucose and ketones he had could be related to another cause other than diabetes such as pancreatitis. Also his drinking binge could have contributed to hyperglycemia and ketones from insulin resistance. Someone who binge drinks even once a week, over time may remain in an insulin resistant state for an extended period of time
 
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#18 ·
Thank you for your reply HJ
My son has always had a problem with alcohol it just doesn't agree with him
from a young age when ever he had drink he was awful the next day, so doesn't often drink, but the night he went out with his pals (someone's 30th)he had got drunk, so wether that had anything to do with it I just don't no, but now 4 months on I'm now starting to wonder if it could be pancreatitis??
What I do no is his diet is fine too and eats a normal,diet but keeps to low carb but still has a dessert like a small piece of chocolate cake or apple pie and custard and still has normal BS readings......I'm so confused HJ to say the least, as I read about diabetes and folk don't seem to eat what they want or have desserts like my son does with no insulin or meds x
 
#19 · (Edited)
have him tested for pancreatitis. There are two types Chronic and Acute

https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis

This link will speak of symptoms, causes, diagnoses, and what pancreatitis is

Pancreatitis symptoms include pain in your upper abdomen that may extend to your back, nausea and vomiting, fever, rapid pulse, and weight loss. Causes include gallstones, heavy alcohol use, medicines, and genetic disorders of the pancreas.

If his test is negative, you can rule it out but keep it mind that drinking has consequences and it not a friend of the pancreas.

*** Have your sons amylase and lipase checked its a simple blood test and comes back quick. often when there elevated there is inflammation in pancreas. i know about these enzymes as i get checked for them for last 15 years (for a organ transplant but if there high, that will promote further investigation on whats behind it
 
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#21 ·
From everything you have said and i have read, your son continues to have good readings over the recent months. You mentioned his fasting of 4, 2 hours after breakfast 5, then 2 hrs after lunch 5 and dinner 6 and all without any insulin or oral meds. He is negative for pancreatitis, has not been on corticosteroids, and has no issue with eating foods high in carbs. I suspect his drinking binge contributed to his hyperglycemia and ketones and temporarily induced insulin resistance back in April.

Knowledge is power and getting a GAD and C-peptide test (post meal is a better indicator than fasting) which Dr already ordered/will order will at very least provide a baseline for comparison in the future and if normal will give you and son peace of mind. I wouldnt be surprised if he has no GAD autoantibodies and more than sufficient production of c-peptide. Good idea to get a hemoglobin A1c test to measure blood sugar levels over last 2 to 3 months. A reading of 5.7 and under is what you want. a 5.7 to 6.4 reading is pre diabetic range and 6.5 and over is classified as diabetes.
 
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#22 ·
Thank you for your valuable information HJ
My son had a hemoglobin A1c done back in May and his specialist said she was pleased with his readings, they were normal, around 5.4
That's when he had his first GAD test done, he then got a abnormal reading from that, so had to have the 2nd GAD test done, which seems to have gone missing....he is waiting for a follow up appointment with her

I've very confused as surely they can't have misdiagnosed him?
I know they said originally his weight (tall and very slim) and age 30 had low ketones in his blood......They assumed he was type 1

My son said he feels something isn't right with his diagnose as he feels great, and looks great too, he seems to be able to eat more or less what he wants, no different tomhow he was before his spike that weekend really.
From your experience on this forum, is there anyone you know of that has had this happen to them, and eventually got soreted one way or the other 🤗x
 
#23 ·
DR's are not infallible and they do not always make the correct diagnoses. An a1c 5.4 is great (in Apr). Hopefully Dr's dont assume a disease or condition without running tests and getting measurable evidence. When a Dr is not sure they can refer a patient to a specialist or talk to another Dr(s). Just because patient had high glucose levels (was 17 mmol or 305) that night in April doesnt mean he has diabetes.
 
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#24 ·
Thank you Hearts Jounrey your information and help has been very helpful, I totally agree Drs, they go by the text books most of the time.
When my son went to hospital that morning I had a feeling he wasn't diabetic
And on return and what he said just didn't sit right with me, and now he has been as normal as you can be we've decided to pay for a private C-petdide test by the time we get this result hopefully the hospital (NHS) will have his GAD Test result ...
I will keep you fully informed...thank you xx

PS I would love to speak to anyone who has had this experience (no insulin, no meds with no raised BG) with type 1
 
#26 ·
That is good news on your sons glucose control to date. Didnt he get an C-peptide done that was going to be paid for privately? Ive had GAD test completed in 3 days and that was 10 yrs ago.
 
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#27 ·
I am not a doctor and dont play one on this website but my opinion is that he was misdiagnosed.

I hope you get the results soon so you can rest easy.

hang in there :vs_cool:
 
#30 ·
htfmrock I do feel he could have been misdiagnosed, but we read a lot about the "honeymoon period" but folk in this, still state they have a lot of spikes and need a small amount of insulin....my son has been nearly 5 months without at end of this month, with his readings been perfect, as with Hearts Jounrey thank you for your reply x
 
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