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Discussion Starter · #1 ·
I had testing done for autoimmune antibodies recently and they were all negative except for one called a GAD65 which said that I was diabetes positive. I then visited with my PCP who ordered an A1C, fasting insulin and fasting glucose. These three came back normal. I am waiting to get copies of these labs as I don't know yet what the levels are. My understanding is that the GAD65 being positive means that I would definitely have LADA or type 1.5, yet my PCP says no. Can anyone enlighten me on this?

Many thanks
koalamoore
 

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I don't know how much light I can shed, but very often it's the case that our PCPs don't really know a lot about diabetes. My own PCP is a little more aware, but prob'ly only because his wife is diabetic.

If you have a choice, line up an endocrinologist to take over your diabetes care. And when you get your labs (good job getting copies - that's a MUST) let us know what your numbers are.

Take care & thanks for joining us!
 

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Discussion Starter · #3 ·
Thank you! I am hoping the results will be in the mail tomorrow. My doctor did seem to be aware of diabetes 1.5 or LADA but said it was very rare and that I had no signs of it. The antibody tests I had were ordered by my neurologist for my seizure disorder and nothing to do with diabetes, but this one positive result did show up. :(
 

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LADA isn't really all that rare, but is often misdiagnosed by - you guessed it - PCPs who make a diagnosis on the basis of age and/or weight, and don't order the tests which could give them a correct diagnosis.
 

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Discussion Starter · #5 ·
Well I am 56 and normal weight. My doctor is awesome but just a one doctor practice. I think I need a referral to see an endocrinologist so not sure how I would get to see one. I am waiting to hear back from my neurologist, who ordered the tests, to see what he thinks, even though it is not his expertise.

Judie
 

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A positive result on a GAD 65 antibody test indicates that you could develop Type 1 diabetes at some point. Some doctors are not up with the latest science. I would think if all your other tests came back normal you just need to watch your bg. It would be good to buy a bg meter and track bgs especially after meal bgs. Sometime 1.5's can be in a honeymoon phase for quite awhile before bgs start to creep into dangeous territory. Also adjusting diet and watching carbs may prolong the honeymoon period.
 
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Well I am 56 and normal weight. My doctor is awesome but just a one doctor practice. I think I need a referral to see an endocrinologist so not sure how I would get to see one. I am waiting to hear back from my neurologist, who ordered the tests, to see what he thinks, even though it is not his expertise.

Judie
You could always ask your neurologist for the referral - just for your diabetes. Retain your regular doc for other things & not suffer him the indignity of referring you to the endo. When he looks at your positive GAD antibodies tests & says you don't show any signs of LADA, I wonder what he thinks those antibodies ARE a sign of? Yes, I agree you need an endo.
 

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Discussion Starter · #8 ·
A positive result on a GAD 65 antibody test indicates that you could develop Type 1 diabetes at some point. Some doctors are not up with the latest science. I would think if all your other tests came back normal you just need to watch your bg. It would be good to buy a bg meter and track bgs especially after meal bgs. Sometime 1.5's can be in a honeymoon phase for quite awhile before bgs start to creep into dangeous territory. Also adjusting diet and watching carbs may prolong the honeymoon period.
Thankyou!! Does having the positive result mean definitely diabetes type I at some time, or just possibly? I have never tested my bgs after a meal but have on occasion used my hubby's meter and tested randomly before a meal. It's always been in the 80's. I will try and watch my carbs but like most people I love them, lol.
 

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Discussion Starter · #9 ·
You could always ask your neurologist for the referral - just for your diabetes. Retain your regular doc for other things & not suffer him the indignity of referring you to the endo. When he looks at your positive GAD antibodies tests & says you don't show any signs of LADA, I wonder what he thinks those antibodies ARE a sign of? Yes, I agree you need an endo.
Thank you, I will ask for a referral if for nothing than my own peace of mind, lol.
 

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So if I am correct, the neurologist ordered GAD-65 testing for you and you have never had abnormal blood sugar results?

You could get an oral glucose tolerance test. Or you could be followed by an endo, with "watchful waiting." There are some studies out that do not indicate that GAD antibodies predispose one to developing Diabetes, ever. I have read all the literature and still think it is meaningful -- especially in my own case.

Be forewarned, even some endos do not believe antibodies indicate inevitable d. I had one endo call me "Type 2, with antibodies." Whatever -- 2 years later, I am using modest amounts of both basal and rapid insulin ... and eating low carb, and exercising.
 

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Discussion Starter · #11 ·
Thank you, that is very helpful. Yes the GAD-65 testing result stated 'diabetes positive'. The other neurological antibody tests were all negative. I have only ever been tested for diabetes as an annual fasting test, just a routine test as part of my annual physical. Results are usually 80 to 100, apparently normal for fasting. What would the oral glucose test show that the A1C, fasting insulin and fasting glucose don't show?

Off to work, many thanks,

Judie
 

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OGTT will show how you go, from a measured amount of glucose. Sometimes,
A1c is not as effective at measuring that.

My brother in law has one kidney, and it is now failing. For YEARS he has been told he is NOT diabetic. They have a strong family history, and he is obese. Finally he saw someone who decided to do an OGTT and voila: he IS Diabetic.

His is an extreme example, but it is still important to know if you are spiking after meals because that is typically the earliest indication of beta cell loss.
 

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There isn't any one definitive test, Judie, but all taken together can give a clearer picture of what's going on. You're a standout because you had the GAD first, which is a pretty lucky break for you in getting doctors' attention early on.
 

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I also test positive for GAD65. My BGs are all over the place (from 600+ to 43). Have had terrible trouble getting effective treatment for some reason. At 195lbs last spring with body fat under 10%, am now down to 160 and almost never feel well. Looks to me like a lot of MDs don't want to make the endo referral unless you're in ketoacidosis. Otherwise, they'll push oral meds till your beta cells give out, which, if you're GAD65 positive, is likely to be sooner rather than later. Trouble is, all the other complications plus med side effects. I'd watch the BGs and start getting serious when they head north of 120 on a regular basis.
 

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Discussion Starter · #16 ·
Thank you all for your answers!! I now have my test results, which as my doctor told me, fall in the normal range. However, feel free to let me know what you think, taking into account my GAD65 was positive!

Fasting glucose - 92 (range is 70-99)
fasting Insulin - 7 (range is 3-25)
Glucose Insulin ratio - 13.1
A1C 5.3 (range 4.8-5.6)
Est Average glucose 105

Judie
 

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Discussion Starter · #17 ·
I also test positive for GAD65. My BGs are all over the place (from 600+ to 43). Have had terrible trouble getting effective treatment for some reason. At 195lbs last spring with body fat under 10%, am now down to 160 and almost never feel well. Looks to me like a lot of MDs don't want to make the endo referral unless you're in ketoacidosis. Otherwise, they'll push oral meds till your beta cells give out, which, if you're GAD65 positive, is likely to be sooner rather than later. Trouble is, all the other complications plus med side effects. I'd watch the BGs and start getting serious when they head north of 120 on a regular basis.
Wow your BG's sure are all over the place! I'd try further to find an Endocrinologist, maybe at your local hospital? Hope you are feeling better soon.

Judie
 

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Thanks, Judie. Going to the doc this afternoon. You are wise to keep alert to this while you are young (I'm making that assumption). At 60, I have always been in what I thought was great shape until late last spring. The discovery of diabetes has led to several other unpleasant problems. One at a time would be a lot more manageable than trying to balance complex, interrelated physical systems as well as trying to manage the equally convoluted psychologies of the various practitioners involved. Anyway, your numbers look great! I pray you can keep them that way.
 

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Discussion Starter · #19 ·
Thanks, Judie. Going to the doc this afternoon. You are wise to keep alert to this while you are young (I'm making that assumption). At 60, I have always been in what I thought was great shape until late last spring. The discovery of diabetes has led to several other unpleasant problems. One at a time would be a lot more manageable than trying to balance complex, interrelated physical systems as well as trying to manage the equally convoluted psychologies of the various practitioners involved. Anyway, your numbers look great! I pray you can keep them that way.
I hope your doctor's appt goes well. Yes, I agree too many specialists, lol. I have a cardiologist as well but don't need to see him very much thank goodness. Oh, and I am not so young, turned 56 this year, lol, so right behind you, lol
 

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Why did they give you a GAD Antibody test. Many type 2's have to fight to get them done because they are not routinely done. From the numbers you posted you do look very normal to me. I would continue to test every so often just to catch any bg spikes in the future. The question about the positive results of the test, I'm not sure the answer. As Foxi said many doctors don't believe in the results. Right now the important thing is that your numbers are great. What happens with LADA's is as time goes on their beta cells are attacked by their immune system, so keep a close eye on insulin levels in yearly testing.
 
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