So have they done a c-peptide test on you? Though a positive GAD test would confirm T1, a negative test doesn't rule it out, and I'd have thought that a c-peptide would be much more conclusive.So got my results back for antibodies today. Negative!! Argggh. So still not sure if T1 or T2 but treating as type 1 at the moment as responding well to the insulin. This disease is soooo confusing.
That one can be inconclusive as well. High = T2, very low = T1 (or 3C), normal, low normal and below normal can be anything. In adults the insulin producing cells tend to take their time dying with T1. And T2 can go unnoticed for a long time, which can compromise insulin production as well.I'd have thought that a c-peptide would be much more conclusive.
I started insulin a month from diagnosis and added mealtime insulin within 2 months. C-pept. and anti GAD were only tested after 2 years, and mainly because I was frustrated by not knowing, not for medical reasons.@Antje77 consultant said pretty much the same to me. He wouldn’t do tests as they are very expensive and often inconclusive. Plus often done too early in diagnosis to actually be reliable. It does actually say in the NHS guidelines tests shouldn’t be done until 6 months in. If I’d had to wait 6 months before starting insulin I doubt very much I would be here now typing this.
I started insulin a month from diagnosis and added mealtime insulin within 2 months. C-pept. and anti GAD were only tested after 2 years, and mainly because I was frustrated by not knowing, not for medical reasons.
Should I have tested a definite T1 my treatment would have stayed the same, bun in case of a clear T2 it would have stayed the same as well because it was working so well.
So now I still don't know for sure but am not frustrated about it anymore.
Besides, most T1's never have their antibodies or C-pept. tested, they get diagnosed by presentation. It's only with the grown ups there may be confusion usually. I'm fine with being diagnosed by presentation.
edit:
And @CC1 , I hope our musings help you with your own feelings and decisions around your diabetes. If you have questions, please ask, maybe we can help
I do think that being diagnosed by 'presentation' is a bit tricky with some people.
To be clear, I was talking about presentation when treatment works, not when you don't get insulin when it's needed. So not the quickly concluding without thinking, but taking every bit of information and deciding that based on a, b and c, the most likely answer is x.Had they done that on presentation I would have probably spent the next 3 months on tablets and become very ill as it turned out I was producing very little of my own insulin.
I'm treated in the NHS Lothian area. The group here, Edinburgh Centre for Endocrinology and Diabetes, publishes a protocol on how to interpret C-pep and GAD tests:
http://www.edinburghdiabetes.com/diabetes-protocols
I'm not a scientist, but my general take on it is that docs know that c-pep and gad tests don't offer as much certainty as folks on this site make out.
It's difficult not to have a clear diagnosis. But even with one, it's difficult to accept such a diagnosis. I would give anything to be able to come off insulin.
NHS guidelines? GAD antibodies only stay around for 6 months after an immune response, so my specialist says. That would be a sure way to miss them. Until your next attack.@Antje77 consultant said pretty much the same to me. He wouldn’t do tests as they are very expensive and often inconclusive. Plus often done too early in diagnosis to actually be reliable. It does actually say in the NHS guidelines tests shouldn’t be done until 6 months in. If I’d had to wait 6 months before starting insulin I doubt very much I would be here now typing this.
I'm treated in the NHS Lothian area. The group here, Edinburgh Centre for Endocrinology and Diabetes, publishes a protocol on how to interpret C-pep and GAD tests:
http://www.edinburghdiabetes.com/diabetes-protocols
I'm not a scientist, but my general take on it is that docs know that c-pep and gad tests don't offer as much certainty as folks on this site make out.
They all said they look at a whole host of markers in order to decide. Very helpful, not, ha ha.
Well I'm a freak then...NHS guidelines? GAD antibodies only stay around for 6 months after an immune response, so my specialist says. That would be a sure way to miss them. Until your next attack.
Guess that means you didn't have a honeymoon period.Well I'm a freak then...
GAD antibodies still in the 'emphatically T1' range after 3 years!
Honeymoon periods are highly overrated in my opinion. Once mine had gone management was so much easier. So much easier to stay in range.