Anti GAD Antibodies - high levels

Lesleywo

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714
Type of diabetes
LADA
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Diet only
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My addiction to carbs
Hi all .... I have insulin resistance, Addisons Disease and Hashimoto's Disease and have been under an Endocrinologist for about 16 years. About 3 years ago he tested me for a lot of different autoimmune diseases and I tested highly positive to GAD ... the range was less than 10 and my reading was 519. He asked if there was any Type 1 in my family - my Mum had an Aunt and Uncle who both were diabetic but not sure which type. Mum diagnosed with Type 2 (diet only) when she was 77 - unfortunately she died a few years back and I have no way of finding out whether the rels were Type 1 or 2.

I am having GAD and C-Peptide test done in November .. just wondering in the meantime .... what do you think my likelihood of getting LADA would be? At present my bloods are HBAlc 5.8%, fasting BS 4.5.

Also, for those with LADA, were your GAD levels very high and if so, how high?

Thanks ever so,

Lesley
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
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Tablets (oral)
It means you have an increased risk of T1 diabetes, the dr will test, to keep an eye on it. It may progress.

If it was me, I'd buy a home meter and test once a week.

Joining this group is a good idea and learning carb counting will be of benefit either way.
If you do progress, knowing carb counting will make it easier
 
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Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
Treatment type
Diet only
Dislikes
My addiction to carbs
It means you have an increased risk of T1 diabetes, the dr will test, to keep an eye on it. It may progress.

If it was me, I'd buy a home meter and test once a week.

Joining this group is a good idea and learning carb counting will be of benefit either way.
If you do progress, knowing carb counting will make it easier
I have a blood glucose monitor and have been doing some testing ... Breakfast today of Sheep Yogurt, Apple, 1T Raspberries, Toasted Almonds & Pepitas - BG 6.8 after 2 hours. I am interested to see how my body handles carbs of various types.. The other day I ate 2 smallish pieces of different cakes (for experimental purposes, you understand!) and after 2 hrs I was 7.3. From this site (and my own testing) I've learned that morning sugars are higher but odd that a Low GI breakfast like today would give that result ... maybe I should have had more cake instead .. Not
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
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Tablets (oral)
You only really need to test once a week or month, your blood glucose will be fine and will get normal results for now and hopefully for a very long time.

Test when you are having a worry, to reassure yourself that it's ok.
When you are having under 8 at 2 hr, it's not too bad
Learn carb counting and play with carbs and how they raise your BG, but be assured, your current results are fine
http://www.phlaunt.com/diabetes/14045524.php
 
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Indy51

Expert
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5,540
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Type 2
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Diet only
Given the high correlation between autoimmune diseases and gluten, I'd seriously consider a gluten free diet. Especially if flour etc is causing higher than usual BG rises. Type 1 and coeliac disease also frequently cluster together.
 

Lesleywo

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Messages
714
Type of diabetes
LADA
Treatment type
Diet only
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My addiction to carbs
Given the high correlation between autoimmune diseases and gluten, I'd seriously consider a gluten free diet. Especially if flour etc is causing higher than usual BG rises. Type 1 and coeliac disease also frequently cluster together.
Thanks Indy, I will see what goes on when I eat bread (which these days isn't that often!) I have been tested for Coeliac and I'm negative.
 

jack412

Expert
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5,618
Type of diabetes
Type 2
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Thanks Jack, will check it out when I get back from the gym ....
Myfitnesspal is a free site and will also help keeping track of carbs.
Lchf diet is also worth looking at
If you start getting regular over 8 at 2 hr, or what level you set yourself. don't put it off but see the dr for an oral med that will stimulate your pancreas
Better long term health is achieved by moving meds when indicated
 
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Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
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Diet only
Thanks Indy, I will see what goes on when I eat bread (which these days isn't that often!) I have been tested for Coeliac and I'm negative.
My understanding of autoimmune diseases goes something like this: intestinal permeability seems to be a factor in most autoimmune conditions; gluten (according to researcher Dr Alessio Fasano) is not fully digestible by any human and is one factor that can cause intestinal permeability. There are also non-coeliac forms of gluten sensitivity. So for anyone with autoimmune conditions, gluten can be problematic. Wheat can also very disruptive to the gut microbiome, which can also have implications for autoimmune conditions. The importance of the gut in many disease processes seems to becoming more and more important in current research.
 
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Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
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Diet only
Dislikes
My addiction to carbs
My understanding of autoimmune diseases goes something like this: intestinal permeability seems to be a factor in most autoimmune conditions; gluten (according to researcher Dr Alessio Fasano) is not fully digestible by any human and is one factor that can cause intestinal permeability. There are also non-coeliac forms of gluten sensitivity. So for anyone with autoimmune conditions, gluten can be problematic. Wheat can also very disruptive to the gut microbiome, which can also have implications for autoimmune conditions. The importance of the gut in many disease processes seems to becoming more and more important in current research.
Yes I have heard that people with autoimmune diseases shouldn't eat gluten :-(
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
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Pump
As you probably realise, Addisons, Hashimotos and T1 are often linked together in what's called a polyendocrine syndrome. . There are similar genetic associations so obviously there is an increased risk as there is of other autoimmune diseases including T1

. However, it isn't just as simple as genetics (if one identical twin gets T1, there is 'only' a 50% chance that his identical sibling will develop it)

I doubt anyone can confidently quantify the risk, other than it is higher than for people without antibodies or other associated conditions. If someone has diabetes then the presence of GAD antibodies helps distinguish T1 from T2. However, GADA is linked to at least one other autoimmune condition and also people without diabetes may have these antibodies.
There are a very few trials where people have been tested for antibodies to see if they would develop diabetes in the future. One large trial, the DCCT tested the relatives of people with diabetes for several antibodies and then looked at them again 10 years later. Those that had several different types of (diabetes) antibodies had a greater risk. Those that had GAD alone had about a 20 % risk over ten years.
http://www.diapedia.org/type-1-diabetes-mellitus/autoantibody-markers

Personally, I know of no evidence that changing diet will prevent the development of T1 . There will certainly be an environmental trigger but results of studies are very conflicting.
There are studies that have looked at the early introduction of cows milk or cereals (ie after weaning) but there are also studies that suggest certain viruses.to be implicated.
I would try not to worry, (hard I know, I have the T1 and the Hashimotos and Addison's is the one I worry about). You will know if your insulin production is lower when the C pep is done. If you have got a lower production then it may be still some years before diabetes develops.
 
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Ian DP

Well-Known Member
Messages
712
Type of diabetes
LADA
Treatment type
Insulin
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Chips
Also, for those with LADA, were your GAD levels very high and if so, how high?

My GAD test was over 2,000. This was done last November. I am still LADA, taking no insulin or meds. Keeping my BG levels averaging 4.6 pre breakfast and 5.6 2hr after meals through LcHf diet.
 
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Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
Treatment type
Diet only
Dislikes
My addiction to carbs
As you probably realise, Addisons, Hashimotos and T1 are often linked together in what's called a polyendocrine syndrome. . There are similar genetic associations so obviously there is an increased risk as there is of other autoimmune diseases including T1

. However, it isn't just as simple as genetics (if one identical twin gets T1, there is 'only' a 50% chance that his identical sibling will develop it)

I doubt anyone can confidently quantify the risk, other than it is higher than for people without antibodies or other associated conditions. If someone has diabetes then the presence of GAD antibodies helps distinguish T1 from T2. However, GADA is linked to at least one other autoimmune condition and also people without diabetes may have these antibodies.
There are a very few trials where people have been tested for antibodies to see if they would develop diabetes in the future. One large trial, the DCCT tested the relatives of people with diabetes for several antibodies and then looked at them again 10 years later. Those that had several different types of (diabetes) antibodies had a greater risk. Those that had GAD alone had about a 20 % risk over ten years.
http://www.diapedia.org/type-1-diabetes-mellitus/autoantibody-markers

Personally, I know of no evidence that changing diet will prevent the development of T1 . There will certainly be an environmental trigger but results of studies are very conflicting.
There are studies that have looked at the early introduction of cows milk or cereals (ie after weaning) but there are also studies that suggest certain viruses.to be implicated.
I would try not to worry, (hard I know, I have the T1 and the Hashimotos and Addison's is the one I worry about). You will know if your insulin production is lower when the C pep is done. If you have got a lower production then it may be still some years before diabetes develops.
Thanks Phoenix, I hear what you're saying .... we seem to get lumped with more than just one of these endocrine disorders don't we? Funny, it's the Type 1 that scares me the most; 'touch wood' I've been lucky with Addisons so far, only take Hydrocortisone and eat plenty of salt. Don't cope too well in the heat (bit unfortunate given I live in Australia!) but there you go, should have stayed in England:)
 

Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
Treatment type
Diet only
Dislikes
My addiction to carbs
My GAD test was over 2,000. This was done last November. I am still LADA, taking no insulin or meds. Keeping my BG levels averaging 4.6 pre breakfast and 5.6 2hr after meals through LcHf diet.
Interesting you had to request a GAD test ... I am already under a Professor in Endocrinology and he's a very inquisitive fellow ... loves blood tests, has tested me for everything under the sun but each visit he scribbles something else on there. Yet the other 2 Endo's I've had only ever tested for the basics (thyroid, LFT, cortosil etc.) This guy has also taken it upon himself to monitor my cholesterol .. I consider myself fortunate to be his patient and still see him even though I've recently moved and have to drive over 2 hours to see him. My only concern is he's near retirement age ... next one has to be younger than me :)
 

Karib

Newbie
Messages
4
Type of diabetes
Type 1
Treatment type
Insulin
My GAD test was over 2,000. This was done last November. I am still LADA, taking no insulin or meds. Keeping my BG levels averaging 4.6 pre breakfast and 5.6 2hr after meals through LcHf diet.
My GAD test was 3200 and I am freaking out. Did they say why you GAD results were so high? I am trying to understand myself.
 

Ian DP

Well-Known Member
Messages
712
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
Chips
Hi Karib,
Welcome to the forum
I am no expert, but I believe any GAD test over 50 indicates an autoimmune condition, and hence T1. Presumably the higher the number the higher the degree. My GAD test was done over two years now, because I have had very stable low BG levels since then I think if I were to have another GAD test done now it would be much lower, but still over 50. I guess the higher the number the quicker you are likely to loose your few remaining insulin making beta cells. Indeed my diabetic consultant told me that because of my high level of GAD I would be on insulin within weeks, as said, that was over two years ago, and I am still not on insulin, and my BG levels are much lower now than then.
Your profile indicates you are a T1 on insulin, was this diagnosis after the GAD test?. What prompted you to have a GAD test?. Has anyone said you are LADA or T1 in the honeymoon period?.
 

Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
Treatment type
Diet only
Dislikes
My addiction to carbs
Hi Karib,
Welcome to the forum
I am no expert, but I believe any GAD test over 50 indicates an autoimmune condition, and hence T1. Presumably the higher the number the higher the degree. My GAD test was done over two years now, because I have had very stable low BG levels since then I think if I were to have another GAD test done now it would be much lower, but still over 50. I guess the higher the number the quicker you are likely to loose your few remaining insulin making beta cells. Indeed my diabetic consultant told me that because of my high level of GAD I would be on insulin within weeks, as said, that was over two years ago, and I am still not on insulin, and my BG levels are much lower now than then.
Your profile indicates you are a T1 on insulin, was this diagnosis after the GAD test?. What prompted you to have a GAD test?. Has anyone said you are LADA or T1 in the honeymoon period?.
From what I've read a GAD positive test is positive, the numbers don't mean anything. I've had 3 GAD tests, first one 519, 2nd around 80 and the 3rd over 100. I have relatively normal blood sugars (a bit of insulin resistance). Neither past or current endo's can tell if I have/will develop LADA. GP says if I was going to get it I would have it by now. Consensus on this forum is that I have a very slow developing LADA in long honeymoon period. C peptide just below middle of range. So I am keeping an eye on my sugars so if anything happens I can catch it early :)
 

Lesleywo

Well-Known Member
Messages
714
Type of diabetes
LADA
Treatment type
Diet only
Dislikes
My addiction to carbs
If you are type 1 diabetic im not sure why you would be concerned about gad antibodies?
 

Karib

Newbie
Messages
4
Type of diabetes
Type 1
Treatment type
Insulin
Hi Karib,
Welcome to the forum
I am no expert, but I believe any GAD test over 50 indicates an autoimmune condition, and hence T1. Presumably the higher the number the higher the degree. My GAD test was done over two years now, because I have had very stable low BG levels since then I think if I were to have another GAD test done now it would be much lower, but still over 50. I guess the higher the number the quicker you are likely to loose your few remaining insulin making beta cells. Indeed my diabetic consultant told me that because of my high level of GAD I would be on insulin within weeks, as said, that was over two years ago, and I am still not on insulin, and my BG levels are much lower now than then.
Your profile indicates you are a T1 on insulin, was this diagnosis after the GAD test?. What prompted you to have a GAD test?. Has anyone said you are LADA or T1 in the honeymoon period?.
Thank you, I had a severe case of DKA, that is why the GAD test was requested. I guess my concern is the high number- 3200. I am thinking I have another autoimmune disease, but not too sure yet.