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LADA (Type 1.5) or not?

10K views 29 replies 6 participants last post by  Tamagno 
#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
 
#2 ·
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!
 
#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. :(
 
#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
 
#7 · (Edited)
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.
 
#6 ·
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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#8 ·
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.
 
#10 ·
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.
 
#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
 
#12 ·
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.
 
#14 ·
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.
 
#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
 
#18 ·
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.
 
#20 ·
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.
 
#22 ·
I have a seizure disorder and a routine MRI was done several months ago. The doctor reading the MRI suggested testing for Paraneoplastic Limbic Encephalitis (quite a mouthful). The tests for this are antibody tests, and the GAD65 is part of the antibody testing. I have no idea why it is included, but I did have a fasting BG of 142 just prior to having the tests ordered. It's possible the neurologist had it added to the antibody testing because of that. I don't get to see him until early next year but will certainly be asking him about it. I have been playing phone tag with him re the results but so far haven't been able to talk to him personally. My hubby has diabetes two and I have been doing random testing using his equipment and so far some results are a little high but nothing to worry about. My doctor is going to do 6 monthly checks to see if there is any change. She'll just use the current results as a baseline.
 
#21 ·
No guys I am a newbie & haven't heard oh the GAD can someone please explain?
 
#23 ·
The big question is why the autoimmune response and can it be slowed or stopped in time to save beta cells. Response to virus? Trauma? Inflammatory condition? Food allergy? Heavy metal poisoning? Environmental toxins? There are just too many variables without direction from a really good, seasoned endo who has actually seen and treated a lot of this. Got to be able to treat the acute condition first to gain time to figure out the chronic. It's just so awfully tiring! In his book "The Problem of Pain," CS Lewis writes something like: "if only this toothache would go away, I could write more about pain." I know the feeling.
 
#25 ·
Glad to hear it, Shanny! Illness has the terrible, insidious and diabolical way of endlessly diverting us from our true selves, our true natures and blinds us when peering through the mirror. However much I'd love to see low BGs, low BP, low creatinine, etc., I'd really just love to feel the peace of wellness!
 
#27 ·
Forgive my musings, Koalamoore! I'm afraid I am sometimes in the habit of philosophizing. This week starts a new round of docs including a new endo. I have been completely unable to tolerate the usual meds all of which resulted in very unpleasant side effects. I thought I was keeping BGs pretty low until I scrolled through the reports on this forum and discovered you all are doing much better. I've run out of room for improvement in diet and exercise, so perhaps the next stop is insulin. Yesterday, the doc actually told me to stop exercising until I gain some weight, or at least stop losing. Wonder what will happen to my numbers if I follow that advice? I've been told that any BGs under 180 are "good enough" for a diabetic. Is it true?
 
#28 ·
'muse' away, lol. I hope your new round of doctors can make you feel 'well' if not cured. Insulin may be the answer too. I work with mentally ill adults and several have diabetes. Insulin does work well for one of our residents, however, he is very uncompliant with diet and exercise so it's a losing battle for him. I can't imagine what would happen if you stopped losing weight - I wasn't aware until just recently that diabetics were not all overweight. Good luck with your appointments.

Judie
 
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