GAD test came positive

[Rahul_Boston]

Doctor called in today and told me that my GAD test came positive.
So looks like I on my way to be Type 1 ( Oh Boy !!).

I insisted on getting this test done as I was feeling very tired and fatigued all the time. On my last visit he said that he will be shocked if it comes positive because he thought I was type 2 as my a1c came to be 5.3.

I am having mixed feelings, on one hand I think I should feel better in terms of fatigue and sleep issues. On the other hand I am nervous about insulin. I hear about the dosage miscalculation and hypo horror stories.

I am celiac and lot of my issues ( headache etc) went away after join on gluten free diet. Now type 1 is also autoimmune disease like Celiac. Does Gluten free diet help both ?

What should be by next course of action ? My doctor still thinks I don't need insulin and he talked to Endo ( from same hospital) and she also thinks the same. I think docs at the same hospital shouldn't be trusted and I should go to an Endo from another hospital .Thoughts ?

[skb]

Diet wise you are already doing the right things, and therefore the BG control and the low A1c. Therapy wise, I would agree with the doctors, and enjoy the honeymoon phase for as long as it lasts. You will only need insulin once your BG starts to go out of whack. Why rush it. Then again, there's always the chance of a mis-diagnosis. Hang on, and cheer up.

[MNB]

If you test a lot, there is no need to fear hypo. Plus, lchf will reduce insulin dosage. Small dose are less likely to result in hypo. Although I have been diagnosed as type 2, I consider myself as type 1 for the simple reason even with strict lchf, I need insulin.The pancreas is not doing much. At a given time I don't take more than 3 units of bolus. That is the max in a single shot. Basal dose is never more than 10 units daily.

[cyclinglady]

I am so sorry the test came back positive, but at least you know where you stand! I would have attributed sleep and fatigue issues to anemia or thyroid (at least in my case).

I too, have celiac disease. Being on the LCHF diet, having food allergies, and intolerances on top of being celiac has been very difficult! The good news is that I have been gluten free for over a year and doing well in terms of reducing my celiac symptoms. I was diagnosed pre-diabetic earlier this year and have been on the LCHF diet for about four months. I'll get re-tested in a few months and if things change, I will get the antibodies testing like you did. I could have asked for it now, but I figured I could be in the "honeymoon" stage and there might not be enough antibodies to get a firm diagnosis of Type 1. My diet and exercise should be enough for now. Of course, I continue to use my meter to test. I have not experienced any lows, so I am hoping that I am a type 2 which does run in my family, but then so does autoimmune RA, thyroid and celiac!

I do not think a gluten free diet will help your diabetes (maybe calm inflammation). It certainly has not brought down my thyroid antibodies, but I was swinging from hyper to hypo for two years prior to my diagnosis, and on top of that, the old menopause which causes all kinds of hormonal swings! All those swings have calmed down. So, maybe the diet does help in some way?

Do you need insulin? I do not know. I hear a lot of pros on starting it early. Taking thyroid hormone replacement (a tiny bit) when my TSH and other thyroid measurements were normal, did not stop my thyroid from progressing 20 years ago. But I will take it, if I am a type 1 and I think I need the insulin. It's just a replacement and if it will help preserve my beta cells, then I'll sign right up.

In the meantime, I'm just working with my GP. He's fine, doesn't have a clue about celiac disease, but I have lived the GF diet for the past 13 years (hubby has it). What are the odds?

I wish you the best. Being a diabetic isn't bad. Having Celiac Disease is worse in a way. You lose a lot of freedom in being able to eat anywhere without fear of cross contamination. I get tired of cooking three meals a day, 365 days a year!

[Rahul_Boston]

Originally Posted by skb

Diet wise you are already doing the right things, and therefore the BG control and the low A1c. Therapy wise, I would agree with the doctors, and enjoy the honeymoon phase for as long as it lasts. You will only need insulin once your BG starts to go out of whack. Why rush it. Then again, there's always the chance of a mis-diagnosis. Hang on, and cheer up.

Thanks !!
About 1.5 years ago I started the gluten free diet and I felt very good overall. Probably that was the start of Honeymoon period :-).
I substituted Gluten free with high Carb diet and after few months started feeling the bad effects.
I have heard transition to full fledged Type 1 can happen in as early as a week and people find out about it in ER after DKA ? I hope I see elevated numbers before that

I am happy that at at least I have so much more information now and better prepared for it than 5 months ago.

[Rahul_Boston]

Originally Posted by MNB

If you test a lot, there is no need to fear hypo. Plus, lchf will reduce insulin dosage. Small dose are less likely to result in hypo. Although I have been diagnosed as type 2, I consider myself as type 1 for the simple reason even with strict lchf, I need insulin.The pancreas is not doing much. At a given time I don't take more than 3 units of bolus. That is the max in a single shot. Basal dose is never more than 10 units daily.

Thanks for your suggestion. I agree with small doses.
Just a question, how many points can 1 unit of bolus decrease the blood sugar?
Does it cause weight gain ? Do you feel less tired after going on it?

[Shalynne]

I am sorry about your Type 1 designation ... but glad you got some answers, however unwelcome.

One thing about being a diagnosed Type 1 ... it should protect you from being denied insulin when you need it.

The fact that you are already testing, and working on a good way of eating, means you are on your way to healthy success! It should save you that trip to the ER, too. When you start spiking on foods that shouldn't spike ... it's time to go for the insulin. Eating LCHF should prevent both spikes and disastrous lows.

(Gluten-free is not always low-carb ... most gluten-free alternatives are actually higher carb than their wheaten counterparts!)

[Rahul_Boston]

Originally Posted by cyclinglady

I am so sorry the test came back positive, but at least you know where you stand! I would have attributed sleep and fatigue issues to anemia or thyroid (at least in my case).

I too, have celiac disease. Being on the LCHF diet, having food allergies, and intolerances on top of being celiac has been very difficult! The good news is that I have been gluten free for over a year and doing well in terms of reducing my celiac symptoms. I was diagnosed pre-diabetic earlier this year and have been on the LCHF diet for about four months. I'll get re-tested in a few months and if things change, I will get the antibodies testing like you did. I could have asked for it now, but I figured I could be in the "honeymoon" stage and there might not be enough antibodies to get a firm diagnosis of Type 1. My diet and exercise should be enough for now. Of course, I continue to use my meter to test. I have not experienced any lows, so I am hoping that I am a type 2 which does run in my family, but then so does autoimmune RA, thyroid and celiac!

I do not think a gluten free diet will help your diabetes (maybe calm inflammation). It certainly has not brought down my thyroid antibodies, but I was swinging from hyper to hypo for two years prior to my diagnosis, and on top of that, the old menopause which causes all kinds of hormonal swings! All those swings have calmed down. So, maybe the diet does help in some way?

Do you need insulin? I do not know. I hear a lot of pros on starting it early. Taking thyroid hormone replacement (a tiny bit) when my TSH and other thyroid measurements were normal, did not stop my thyroid from progressing 20 years ago. But I will take it, if I am a type 1 and I think I need the insulin. It's just a replacement and if it will help preserve my beta cells, then I'll sign right up.

In the meantime, I'm just working with my GP. He's fine, doesn't have a clue about celiac disease, but I have lived the GF diet for the past 13 years (hubby has it). What are the odds?

I wish you the best. Being a diabetic isn't bad. Having Celiac Disease is worse in a way. You lose a lot of freedom in being able to eat anywhere without fear of cross contamination. I get tired of cooking three meals a day, 365 days a year!

Thanks for taking time to write a detailed post for me.

We are in the same boat with Celiac and Diabetes. You are right in a way that celiac is tougher than diabetes. If you eat gluten you have to pay the price, with diabetes you can get away with it with exercise or insulin.
However being already on a GF diet prepares us for LCHF or low carb diet better.

Does the number of antibodies give any clue regarding how close you are to full blown Type 1? I didn't ask my doc about it.

I think I need insulin, maybe start with low dose. I think that way I can have a better control with diet and exercise and keep my numbers low and feel better at the same time. However all depends on Endo, if they think that too :-)

[skb]

Originally Posted by Rahul_Boston

Thanks for your suggestion. I agree with small doses.
Just a question, how many points can 1 unit of bolus decrease the blood sugar?
Does it cause weight gain ? Do you feel less tired after going on it?

Here too YMMV rules. You will have to test a lot initially (whenever) and find out your Insulin : Carbs ratio. It's your own and not applicable to the next guy. This way the dosage has to be very carefully titrated.

[Rahul_Boston]

Originally Posted by Shalynne

I am sorry about your Type 1 designation ... but glad you got some answers, however unwelcome.

One thing about being a diagnosed Type 1 ... it should protect you from being denied insulin when you need it.

The fact that you are already testing, and working on a good way of eating, means you are on your way to healthy success! It should save you that trip to the ER, too. When you start spiking on foods that shouldn't spike ... it's time to go for the insulin. Eating LCHF should prevent both spikes and disastrous lows.

(Gluten-free is not always low-carb ... most gluten-free alternatives are actually higher carb than their wheaten counterparts!)

Thanks for your encouraging words !!
I also feel good that I got the correct categorization for my condition. This is only possible due to wealth of info on the forum and valuable suggestions from all of you.