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Diagnosis Advice GAD Test?

C

Chalski

Newbie
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1
Type of diabetes
Family member
Treatment type
I do not have diabetes
Hello there!

We are new here but have been using the website as a guiding light for some time!

My partner has a family history of DM but it is now suspected LADA, his relation is awaiting confirmation of this.

He has suffered for years with the classic symptoms of Type 2 but is only 31 and not overweight, therefore having had a fasting blood test hid GP has concluded whilst there might be something wrong with him there is no point doing further testing unless he gets iller! Over Christmas he was very unwell after breaking our usual diabetes friendly diet in order to eat lots like a non-diabetic person should be able to! We are now back on our usual eating plan and he is much better but still not "normal" and we are at a loss as to where to go from here.

We wondered if anyone else has had a GAD test done privately and if this has been of benefit? He has the information about getting a Glucose Tolerance test done on the NHS but has been warned that the test may only prove Glucose impairment.

Any advice would be greatly welcomed.

Thank you!
 
I had a GAD test as I was initially thought to be T2 as well. I never went private, I was just fortunate to be given one. I have since learned that many are not afforded the same luxury. I am not sure if there is any other way of telling ? I'd bet there are 1000's out there who are misdiagnosed as T2 but really have the auto-immune type. Can you try another doctor and request a GAD ?


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In his situation I would buy a Glucose Monitor from a chemist.

He should test blood sugar upon waking and two hours after meals as well as at any time he feels odd or unwell. If the monitor is recording blood sugar numbers consistently above 7 post the results here for further advice.

A meter will be much cheaper than a GAD test!
 
Yes, do get a meter and monitor what is going on. If your partner has elevated blood sugar (perhaps into the teens or even higher mmol) then LADA at age 31 and not being overweight it very likely. Like Mo I was just dumped into the T2 category based on a urine stick test by the expert diabetes GP. A lot of these T2s remain mis-diagnosed for years depending on the GP many of whom haven't even heard of LADA. I gave up with my GP when I had to starve myself and had both a GAD and c-peptide test done privately by Medi-checks. The GAD test was negative but the c-peptide showed I had virtually no insulin i.e. not a T2. So, the GAD test if positive is conclusive but a negative result isn't conclusive against LADA as there are many causes of pancreatic failure. So, in summary if the meter readings show elevated blood sugar get the GP to confirm diabetes and have the discussion ref LADA. Sadly you may have to push quite hard or do what I did and go along with tablets for while and push for insulin when needed. I never told my GP about my test results as she finally realised I needed insulin (as a 'T2' of course)
 
The GAD test will confirm whether he has autoimmune diabetes, a meter won't do that although he should still have one to monitor at home. A c-peptide is needed as well as the GAD really to give any sort of information. I have had both done but to be honest they've stopped doing them now and have told me to just sit and wait to deteriorate.

I was diagnosed over a year ago and there has been no change in my condition and I am still not on insulin. The truth is the doctors in this country know naff all about LADA really and we are miles behind Scandinavian countries. The attitude in this country is to just treat with insulin when things get bad rather than trying any sort of prevention or prolonging of health..... Really irritates me to be honest but what can u do.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
Hi again. Elaine has summarised my views. If your meter shows you have diabetes and a sensibly low-carb diet and tablets don't control it adequately then be prepared to pay for private tests if the GP won't play ball. I could only find Medi-checks but there may be others. There is a discount for having two tests done. Google 'lab tests' etc when the time comes. In the early days of LADA tablets will work for most. LADA can move fast or as in my case it took years to progress; there are no rules. NICE recommends three levels of tablets to manage a high HBA1C and then insulin. I went thru three tablets and each helped along the way but eventually failed meaning increasingly fewer carbs to control the sugars. The meter is the key to all of this.
 
I was diagnosed as LADA 6 weeks ago, through a GAD test via GP. I requested the test, after researching about LADA here and on the web. I think I put a strong case to my GP and he agreed to the test. Diabetic doc then told me to stop taking all meds, and to contact him again when I can not keep BS levels below 10, when he will put me on insulin.

Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. prescribed Metformin and Gliclazide. Went on zero processed sugar and low carb diet, got my BS levels averaging 5.5 (now around 6). Requested a GAD test in November, came back very high 2,000+, doc says I will be T1 soon, but presently LADA.



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Hi Ian, Metformin is a really good drug and although many people seem to think tablets don't work at all with LADA, Metformin really helps me use what insulin I have to the best of its ability. During a changeover period between standard Metformin and the slow release kind my BS shot up by 3mmol post prandial then settled straight back down once I had been on the slow release Metformin for a couple of weeks.

It might not help but it just might and so might be worth considering discussing it with ur GP before any insulin treatment if your BS go up but not massively


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
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Yes, I saw some research results on the web which showed that having Metformin with insulin did reduce blood sugar by a bit, so it does have some effect presumably by dropping the liver's output of glucose. Ian, I might have expected your GP to have used further HBa1C tests to indicate a move to insulin following NICE Diabetes Pathways i.e. a reading above 7.5 when tablets have failed. His approach seems slightly quirky but may well hit the right end result. If your next HBa1C is above 7.5% then you may well then want to ask for insulin. He should be doing these every 3 months now as you are borderline?
 
Yeh, Daibell has a point, I would presume they would monitor u more closely? I was diagnosed December 2012 and I seen them February, June and then November 2013.. My first hba1c from before diagnosis was 83.

They have now put me back onto a yearly review as my June Hba1c was 45 and my November one was 49... "Wait to deteriorate" I guess....


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 

Still going strong elaine

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Hmm I duno Brett it's so frustrating coz none of them have a clue about my condition and telling me to wait to deteriorate just makes me feel like I've been told I'm terminal! It's awful..... Still 45 to 49 is a small deterioration lol


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 

Are you able to check things yourself in between then monitoring you?

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Yeh I have a meter and strips but I hardly test now coz nothing ever changes it's always the same... 7.3mmol in the morning, 4.9mmol before tea and then evening depends on how rebellious ive been with my evening meal lol. I keep changing my mind as to whether this "nothing happening" is a good or a bad thing...


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
Its a good thing lol, but also good to keep at the back of the mind and test occasionally to catch any change early. Suppose you are a human ticking bomb.

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Elaine, boring, predictable BG levels are GOOD ! Don't wait for doom and gloom just enjoy the fact you've delayed your diabetes this long and are still managing great control. One day, and I hope it's a long way off, you'll look back and realise how well you managed.


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Hi Elaine, I am keeping my Metformin back until my BS go up regularly above 7, at the moment with diet I am keeping them averaging below 6.
Hi Diabell, my last HBa1c was 6.3 (nov), in September on diagnosis it was 9.4. GP wants another HBa1c in February, so looks like every 3 months. I am monitoring my BS levels 2 or 3 times per day.

Diabetic doc said that with my BS levels as they are he would not want me on insulin as I would hypo to easily. When my BS levels go up and / or if I continue to lose weight he will put me on insulin. My weight has been stable for last 4 weeks.
I joked that I hopefully would not see him again for a year or two, he replied 'I think a couple of months'.
I asked him why I had to request a GAD test through my GP, and he had not requested it. He blushed, swallowed, thought for a few seconds and replies 'nhs budget restraints'..... An honest answer I thought.

I have to say that overall I am happy with my hospital diabetic doctor and nurse support, and also my GP and GP diabetic nurse support. Most advice tallies with advice on here, but I feel that in order to get best support I have had to educate myself, to enable me to ask informed questions, and this forum is great for enabling that awareness.

Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. prescribed Metformin and Gliclazide. Went on zero processed sugar and low carb diet, got my BS levels averaging 5.5. Requested a GAD test in November, came back very high 2,000+, doc says I will be T1 soon, but presently LADA.



Sent from the Diabetes Forum App
 
Yep Ian, my consultant said the same! Levels not high enough for insulin.... I'm usually always above 7 post prandial though. Usually between 6.5 and 8 mmol unless I've had almost zero carbs..


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
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