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How do I convert from U/ML into nmol/L?

bluedeep

bluedeep

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi all - I am new to the forum (and diabetes too) and am in the process of being diagnosed if I am Type 1 LADA. I have done my GAD65Ab test a few weeks ago and just got the results in electronically. But will have an appointment with my doctor in about two weeks. So, naturally, I am trying to read and interpret the result myself but find this very difficult and frustrating because the measuring units in the articles I read on the web do not match the measuring units I see in the report. I should probably mention that I am located in Canada and the report maybe using some nomenclature used in Canada and US.

My report prints my result in measuring units U/ML. And it says that the reference range is <= 1.0 U/ML. My result is quite higher, but I can't gauge exactly what this means if I compare it with the information I read online where the measuring units are nmol/L. And the reference range is <= 0.02 nmol/L. I am guessing my results point to Type 1 LADA but am not completely sure...

How do I convert from U/ML into nmol/L?

Really appreciate the help!
 
bluedeep said:
Hi all - I am new to the forum (and diabetes too) and am in the process of being diagnosed if I am Type 1 LADA. I have done my GAD65Ab test a few weeks ago and just got the results in electronically. But will have an appointment with my doctor in about two weeks. So, naturally, I am trying to read and interpret the result myself but find this very difficult and frustrating because the measuring units in the articles I read on the web do not match the measuring units I see in the report. I should probably mention that I am located in Canada and the report maybe using some nomenclature used in Canada and US.

My report prints my result in measuring units U/ML. And it says that the reference range is <= 1.0 U/ML. My result is quite higher, but I can't gauge exactly what this means if I compare it with the information I read online where the measuring units are nmol/L. And the reference range is <= 0.02 nmol/L. I am guessing my results point to Type 1 LADA but am not completely sure...

How do I convert from U/ML into nmol/L?

Really appreciate the help!
Click to expand...
You could phone the lab and ask them, or try googling to find a conversion website, that's what I usually do.

I'm guessing these units of measure are units per millilitre and nanomole per litre?
 
The lab I went to just took the blood sample and send it elsewhere. I think they said to somewhere in the U.S. so I don't think they can help. And besides in Canada if you ask what the results mean - you will be told to talk to your doctor since they are not allowed to comment.

I did a lot of searching and googling for the conversion but no luck. There are many different sites but none that I can figure helps with this particular conversion. I spent more than an hour. Of course, it's possible I'm missing something.

Yes, I believe these are most likely units per millilitre and nanomole per liter, but that's as far as I got googling.
 
Actually maybe this will help: can someone tell me or point me to an article that spells out what GAD65Ab reading is the threshold above which you are considered Type 1 LADA?
 
I'm not an expert
but I think that you are looking at results using different types of assay The test used by most labs recently seems to be an immunosorbent assay (ELISA). The results of these are given in International units. From what I read here the results expressed with a ref range of < or =0.02 nmol/L may from a different sort of assay. http://thetinman.org/endocrine.html
Reference ranges will though vary still between labs..
Heres the reference range given by Southend NHS lab( with caution reference ranges will vary between labs, there is evidently some difference between your lower figure and this one)
"
Reference Range
Results should be interpreted as follows

Negative result is 0-5.0 U/ml

Equivocal result is 5.1-25.0 U/ml

Positive result is >25.0 U/ml
Please note: Anti GAD antibodies are found in 65 - 85% of patients with Type I Diabetes, in 70 - 90% of patients with LADA, approximately 80% of healthy relatives of patients with Type I Diabetes and a small percentage of patients with Type II Diabetes. Levels are generally low in Diabetes (<100 U/mL).

A recent case study on a young man originally diagnosed with type 2 using a GADA test with the same range resulted in a change of diagnosis .

"Presumptive diagnosis of LADA was made with positive C-peptide level (1.10 ng/mL; NR: 0.8 - 3.1) which was later confirmed by positive GAD-65 antibodies (13.1 U/mL; negative is 0 - 5 U/mL) http://www.journalmc.org/index.php/JMC/article/viewFile/2183/1582

Harmonisation of assays and Units is in progress but it takes a long time to get laboratories in many different places to use the same procedures and units. http://www.ncbi.nlm.nih.gov/pubmed/20444913 (not there in 2010 )

If you look at many studies even quite recently , you'll find they used arbitrary units with absolutely no relationship from one to another
 
Last edited by a moderator:
Thank you, @phoenix. This was very informative.

The problem for me now is that I am actually far more worried than before I knew/read this. My number is definitely placing me as Type 1 LADA, but there is potentially more than this: if I am reading all correctly, then I am 27 times (!) above the threshold. And so LADA can be just one of my - potentially longer - list of problems...

From this article here <http://thetinman.org/endocrine.html> I learnt that different Labs develop their own reference ranges and that there are three main ways to measure GAD65 (this below is a quote):

There are three ways to measure GAD65 antibodies: radio-immune assay (RIA), radiobinding assay (RBA) and enzyme-linked immunosorbent assay (ELISA). Labs develop their own reference ranges and results may vary by location:

(1) RIA levels of GAD65: [Source: Mayo Clinic]
-> For type 1 diabetes (and to differentiate from type 2 diabetes), thyroiditis, pernicious anemia, titers are generally < or =0.02 nmol/L.
-> For stiff-person syndrome, autoimmune encephalitis, cerebellitis, brainstem encephalitis, and myelitis, titers are generally > or =0.03 nmol/L.
-> For myasthenia gravis, Lambert-Eaton Syndrome, and dysautonomia, titers are < or =0.02 nmol/L.

(2) ELISA levels of GAD65 [Source: Genway/Mayo Clinic/Athena Labs]
-> Negative = <5.0 IU/mL
-> Positive = > 5.0 IU/mL

(3) RBA levels of GAD65 [Source: Quest]
-> Negative = ≤1.0 U/mL
-> Positive = >1.0 U/mL​

And my report says literally just this one line:

Glutamate Decarboxylase 65 Ab: 27.3 U/ML. [Reference range is < or = to 1.0 U/ML]
​
So, the logical way to read my report is that my lab is using method #3 above (highlighted in red), and therefore my reading of 27.3 is 27 times bigger than the threshold of 1.0. Quite scary. I would much prefer if my lab was using method #2 or the method described by @phoenix where positive result is >= 25.0 U/ML since these methods while still placing me as LADA, have a much smaller difference with the threshold. I guess I will still need to wait for my doctor's appointment in about 2 weeks and am hoping I am somehow reading this wrong...

Does my thinking make sense?
 
bluedeep said:
Thank you, @phoenix. This was very informative.

The problem for me now is that I am actually far more worried than before I knew/read this. My number is definitely placing me as Type 1 LADA, but there is potentially more than this: if I am reading all correctly, then I am 27 times (!) above the threshold. And so LADA can be just one of my - potentially longer - list of problems...

From this article here <http://thetinman.org/endocrine.html> I learnt that different Labs develop their own reference ranges and that there are three main ways to measure GAD65 (this below is a quote):

There are three ways to measure GAD65 antibodies: radio-immune assay (RIA), radiobinding assay (RBA) and enzyme-linked immunosorbent assay (ELISA). Labs develop their own reference ranges and results may vary by location:

(1) RIA levels of GAD65: [Source: Mayo Clinic]
-> For type 1 diabetes (and to differentiate from type 2 diabetes), thyroiditis, pernicious anemia, titers are generally < or =0.02 nmol/L.
-> For stiff-person syndrome, autoimmune encephalitis, cerebellitis, brainstem encephalitis, and myelitis, titers are generally > or =0.03 nmol/L.
-> For myasthenia gravis, Lambert-Eaton Syndrome, and dysautonomia, titers are < or =0.02 nmol/L.

(2) ELISA levels of GAD65 [Source: Genway/Mayo Clinic/Athena Labs]
-> Negative = <5.0 IU/mL
-> Positive = > 5.0 IU/mL

(3) RBA levels of GAD65 [Source: Quest]
-> Negative = ≤1.0 U/mL
-> Positive = >1.0 U/mL​

And my report says literally just this one line:

Glutamate Decarboxylase 65 Ab: 27.3 U/ML. [Reference range is < or = to 1.0 U/ML]
​
So, the logical way to read my report is that my lab is using method #3 above (highlighted in red), and therefore my reading of 27.3 is 27 times bigger than the threshold of 1.0. Quite scary. I would much prefer if my lab was using method #2 or the method described by @phoenix where positive result is >= 25.0 U/ML since these methods while still placing me as LADA, have a much smaller difference with the threshold. I guess I will still need to wait for my doctor's appointment in about 2 weeks and am hoping I am somehow reading this wrong...

Does my thinking make sense?
Click to expand...
I don't think you need to be concerned about it at this point. Being significantly higher than the ref range one lab uses doesn't necessarily mean things are really bad. The key is, what are your BGs like today and how do you feel?
 
Thanks for asking @CatLadyNZ. I am in my 40-s and discovered I have a problem about 6 weeks ago when on a routine blood test my fasting BG was 18.7. Quite a shock since I had a BMI of 25, am quite active and basically don't really consume much sugar other than fruit. But during that time my BG after meals was climbing to at the highest 29... Strange thing is I wasn't feeling it in the sense that I wasn't tired or feeling dizzy, or having blurred vision, or anything outside of extra thirst and urination. And rapid weight loss.

The last time I measured my BG before the very high reading was about 6 months ago and it was then 6.0. Basically I developed diabetes in the course of just a few months. Doing it so fast, I understand, is an indication for type 1.5. And had one other clear indication of type 1.5 which is that I lost 50 pounds in just 2 to 3 months. Now my BMI is 20 and am still having trouble gaining weight.

My doctor put me on metformin 2 times a day 1000 mg each. And I changed my diet and started being even more active than before. So, my BG started going down almost daily and about 2 weeks ago the fasting BG got down to around 7.0 and it has been fluctuating there ever since. Basically, all my daily readings are usually between 4.5 and 7.3. The metformin has helped. And also, I may be experiencing the honey moon period.

In spite of the very high BG readings, I never felt really sick in any way both now and before. And the BG is now more or less under control. But the whole rapid development, the massive weight loss and now the very high GAD64 Ab reading makes me worried. I am dreading the possibly that the diabetes I have may not be the only problem. Reading about very high GAD antibodies and all possible implications (including the ones outside diabetes) is quite an unpleasant ordeal right now...
 
bluedeep said:
Thanks for asking @CatLadyNZ. I am in my 40-s and discovered I have a problem about 6 weeks ago when on a routine blood test my fasting BG was 18.7. Quite a shock since I had a BMI of 25, am quite active and basically don't really consume much sugar other than fruit. But during that time my BG after meals was climbing to at the highest 29... Strange thing is I wasn't feeling it in the sense that I wasn't tired or feeling dizzy, or having blurred vision, or anything outside of extra thirst and urination. And rapid weight loss.

The last time I measured my BG before the very high reading was about 6 months ago and it was then 6.0. Basically I developed diabetes in the course of just a few months. Doing it so fast, I understand, is an indication for type 1.5. And had one other clear indication of type 1.5 which is that I lost 50 pounds in just 2 to 3 months. Now my BMI is 20 and am still having trouble gaining weight.

My doctor put me on metformin 2 times a day 1000 mg each. And I changed my diet and started being even more active than before. So, my BG started going down almost daily and about 2 weeks ago the fasting BG got down to around 7.0 and it has been fluctuating there ever since. Basically, all my daily readings are usually between 4.5 and 7.3. The metformin has helped. And also, I may be experiencing the honey moon period.

In spite of the very high BG readings, I never felt really sick in any way both now and before. And the BG is now more or less under control. But the whole rapid development, the massive weight loss and now the very high GAD64 Ab reading makes me worried. I am dreading the possibly that the diabetes I have may not be the only problem. Reading about very high GAD antibodies and all possible implications (including the ones outside diabetes) is quite an unpleasant ordeal right now...
Click to expand...
I don't think there is anything to worry about on the diabetes front. I think your FBGs should slowly come down, and you might need to give them a helping hand with insulin if they don't. If your BGs start to climb again, then you should be able to control things with insulin. I hate to see people worrying... what are the possible implications outside diabetes?
 
I hate to see people worrying... what are the possible implications outside diabetes?
Click to expand...

I've been reading about all sorts of other possible neurological complications that a high GAD65Ab test indicates. For example: high result means diabetes 1.5, but even higher result means potentially diseases such as SPS (http://www.medscape.com/viewarticle/751794).

There is a long list actually and I haven't read about all of them: http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81596.

Quote from link above: "Antibodies directed against the 65-kd isoform of GAD (GAD65) are seen in a variety of autoimmune neurologic disorders including stiff-man (Moersch-Woltman) syndrome, autoimmune cerebellitis, brain stem encephalitis, seizure disorders, neuromyelitis optica and other myelopathies, myasthenia gravis, Lambert-Eaton syndrome, and dysautonomia."
 
bluedeep said:
I've been reading about all sorts of other possible neurological complications that a high GAD65Ab test indicates. For example: high result means diabetes 1.5, but even higher result means potentially diseases such as SPS (http://www.medscape.com/viewarticle/751794).

There is a long list actually and I haven't read about all of them: http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81596.

Quote from link above: "Antibodies directed against the 65-kd isoform of GAD (GAD65) are seen in a variety of autoimmune neurologic disorders including stiff-man (Moersch-Woltman) syndrome, autoimmune cerebellitis, brain stem encephalitis, seizure disorders, neuromyelitis optica and other myelopathies, myasthenia gravis, Lambert-Eaton syndrome, and dysautonomia."
Click to expand...
As far as I know, you don't have symptoms of those disorders and I don't think you have firm information suggesting you are likely to get them. I know it's easier to say than believe, but I don't think there is anything to worry about at this stage. If these "possibilities" are an issue, your doctor will tell you and give you information at that time. If they are not, then you have gone through all this worry for nothing.
 
I know it's easier to say than believe, but I don't think there is anything to worry about at this stage. If these "possibilities" are an issue, your doctor will tell you and give you information at that time. If they are not, then you have gone through all this worry for nothing.
Click to expand...

I know you're right. Worry is a pointless exercise and I need to learn to ignore it. Only excuse I have is that it all happened so quickly that it shocked me and now I need to unwind myself.

Thank you for being very supportive! Cheers!
 
Hi, first all those other problems you mention are extremely rare and you would have had symptoms. Also more doesn't really mean worse, and conversely less better. (I don't know what my GAD antibodies were but I do know that my thyroid ones were very high but what was important is the fact they were there,not there number)

Second if it is T1 or LADA rather than T2 diabetes then you will have a condition that you can control and with which you can do anything that you want it doesn't have to stop you. There have been T1s on the top of Everest and T1s on the gold medal platform at the Olympics. When I was diagnosed, I thought I had T2 was completely shell shocked to be taken into hospital and put on insulin (that probably wouldn't have happened quite in that wayin many countries) but my time in hospital made me determined that it wasn't going to make me into a 'sick' person. I went out and trained for a marathon to make that quite clear to both myself and everyone around me. It's almost eleven years now and I no longer run marathons but I think than I am far fitter than I was pre diabetes.
 
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