GAD, C Peptide, Islet - what?

[LunaCrystal]

So I got my test results back but I don't understand them, does anyone know? I don't have another appointment until August.

GAD - >2000
C Peptide - 1.08
Islet - Positive

 

[Bognorlad40]

All I can help here with is the islet are the cells in the pancreas that has something or other to do with insulin production and
A GAD test is a blood test which measures whether the body is producing a type of antibody which destroys its own GAD cells. In type 1 diabetes, a number of autoantibodies are thought to circulate including those which target glutamic acid decarboxylase. Presence of these autoantibodies suggests type 1 diabetes.

 

[Bognorlad40]

And if I remember my stuff right I think the A C-peptide test is a blood test which is carried out to find out how much insulin your body is producing. This may be useful for determining whether you have type 1 or type 2 diabetes or whether you have insulin resistance.

 

[Ian DP]

My GAD was also over 2,000. Dr straight away said that means I am a T1, in the honeymoon period. NHS does not seem to recognise LADA, but that's how I see myself, but it's not on my NHS records, just T1 honeymoon. There is a lot of evidence around that indicates that if you can Keep your bg levels low the honeymoon period can last many years. I have never had a cpeptide test. Dr days it's not worth doing for me. Whilst in the honeymoon period your body still produces some insulin.

 

[Bognorlad40]

That's true the nhs does not recognise lada just type 1 and 2 which I don't understand why that's the case

 

[LunaCrystal]

How have you gone about keeping your bg levels down? Is it a case of diet and exercise or is there medication as well?

 

[Shar67]

NHS do recognise other types of diabetes but it depends on the doctor, they use type 1 and 2 for type of treatment and if diabetes is non production of insulin or insulin resistance.

 

[Pinkorchid]

So how do some people know they are Lada if it is not recognised

 

[Ian DP]

How have you gone about keeping your bg levels down? Is it a case of diet and exercise or is there medication as well?

Diet (low carb high fat) and exercise. I follow dr Bernstein solution book. Around £5 on kindle or iBook. No meds.

 

[Ian DP]

So how do some people know they are Lada if it is not recognised

By reading / learning about it, here on this forum and books

 

[LunaCrystal]

Diet (low carb high fat) and exercise. I follow dr Bernstein solution book. Around £5 on kindle or iBook. No meds.

Thanks for answering. I've seen a lot of recommendations for the book so will definitely be reading it.

 

[cz_dave]

So I got my test results back but I don't understand them, does anyone know? I don't have another appointment until August.

GAD - >2000
C Peptide - 1.08
Islet - Positive

Welcome to the LADA community! A few questions:

1. Would you know what's the normal range for your C-peptide test? My last C-peptide result was 0.31 nmol/l and that's below the normal range (0.37) but still quite good for a Type 1/LADA diabetic.
2. What are your fasting and post-prandial (2 hours after eating?) levels? Waiting until August seems a bit long. If I was you I would get a blood glucose meter and try to find out.
3. In the meantime, you can try follow a low-carb diet.

Don't be afraid of being put on insulin. Taking insulin can help you retain whatever the remaining capacity you have for your body's insulin production.

 

[Pinkorchid]

I just wondered then what makes some people in the first place think that they may be Lada and not T2 or T1 before they even read up about it how is it different to T1 or T2

My son was treated as a late onset T1 for about 6 years then he moved home and his a new doctor doubted he was T1 because of the problems he was having adjusting the insulin to suit him and he was having a lot of hypos. He saw a consultant who thought he was more likely to be T2 or possibly Lada but tests were not conclusive on that so he is now treated as T2 and is taking Metformin and Gliclazide and he is fine and no more hypos..He definitely does not follow a low carb diet he eats more or less anything but low on the sugar stuff he was told by the doctor he needs the carbs when taking Gliclazide to prevent BG levels falling to low and told him to try not to go lower than about 7's

 

[zand]

I just wondered then what makes some people in the first place think that they may be Lada and not T2 or T1 before they even read up about it how is it different to T1 or T2

My son was treated as a late onset T1 for about 6 years then he moved home and his a new doctor doubted he was T1 because of the problems he was having adjusting the insulin to suit him and he was having a lot of hypos. He saw a consultant who thought he was more likely to be T2 or possibly Lada but tests were not conclusive on that so he is now treated as T2 and is taking Metformin and Gliclazide and he is fine and no more hypos..He definitely does not follow a low carb diet he eats more or less anything but low on the sugar stuff he was told by the doctor he needs the carbs when taking Gliclazide to prevent BG levels falling to low and told him to try not to go lower than about 7's

That's because Gliclazide works by making the pancreas produce more insulin. The problem is it could well make the pancreas wear out before its time. It astonishes me that someone would be advised to up the carbs to suit the Gliclazide! Why not lower the carbs to suit the pancreas and thereby ditch the drugs? Crazy!

 

[Pinkorchid]

That's because Gliclazide works by making the pancreas produce more insulin. The problem is it could well make the pancreas wear out before its time. It astonishes me that someone would be advised to up the carbs to suit the Gliclazide! Why not lower the carbs to suit the pancreas and thereby ditch the drugs? Crazy!

I could not say if the advice he had was bad for him or not as I am no expert so it is between him and his HCP's. As we always say on here we are all different so need different things. I don't think he was actually told to eat more carbs but just to eat normally....apart from having the sugar stuff of course... because Gliclazide can cause hypos if the blood goes to low. Incidentally he had never heard of the LCHF diet for diabetes until I told him about it but he said he would not want to eat that way. He has never been a low fat eater though and he is not overweight never has been.

 

[zand]

I could not say if the advice he had was bad for him or not as I am no expert so it is between him and his HCP's. As we always say on here we are all different so need different things. I don't think he was actually told to eat more carbs but just to eat normally....apart from having the sugar stuff of course... because Gliclazide can cause hypos if the blood goes to low. Incidentally he had never heard of the LCHF diet for diabetes until I told him about it but he said he would not want to eat that way. He has never been a low fat eater though and he is not overweight never has been.

As long as he is happy for his beta cells to potentially stop working eventually so that he will need insulin again then that's fine, that's what is right for him.

edit: the reason the bloods can go too low on Gliclazide is that it can make the pancreas over produce insulin, hence the danger of the beta cells eventually wearing out. If he and his HCP's are happy with the situation then that's fine. I do hope they have warned him of the possibility and not just told him what drugs to take. Of course they will have, as you say they are the experts, but it might be an idea to check with your son just in case.

 

[cz_dave]

I just wondered then what makes some people in the first place think that they may be Lada and not T2 or T1 before they even read up about it how is it different to T1 or T2

This is an interesting point. I may be wrong but I guess LADA as an official diagnosis (distinct from T1 and T2) is not recognized in most healthcare systems. Most LADAs have been diagnosed as T1 (or misdiagnosed as T2). I think LADA really belongs in the T1 family as it is an autoimmnune condition.

 

[Pinkorchid]

As long as he is happy for his beta cells to potentially stop working eventually so that he will need insulin again then that's fine, that's what is right for him.

edit: the reason the bloods can go too low on Gliclazide is that it can make the pancreas over produce insulin, hence the danger of the beta cells eventually wearing out. If he and his HCP's are happy with the situation then that's fine. I do hope they have warned him of the possibility and not just told him what drugs to take. Of course they will have, as you say they are the experts, but it might be an idea to check with your son just in case.

He is probably happy with what the consultant has told him and would not take any notice of me if I said I did not think it was very good advice but then I expect there are thousands like him who will only ever take the advice of their medical team Both me and his dad have T2 and he thinks we are mad to follow a lower carb diet cutting out rice pasta potatoes etc

 

[ann34+]

This is an interesting point. I may be wrong but I guess LADA as an official diagnosis (distinct from T1 and T2) is not recognized in most healthcare systems. Most LADAs have been diagnosed as T1 (or misdiagnosed as T2). I think LADA really belongs in the T1 family as it is an autoimmnune condition.

i asked my teaching hospital consultant about this recently, specifically about 1.5, and as you say they only see type 1 or type 2. within the type 1 there are the slow onset, very slow onset type 1s and the fast onset. as far as i understand it, the older you are the more likely for type one to be slow onset. I was asking if i was really Type one, having read some of the threads here, and having had years of ill health and non diagnosis many years ago. On diagnosis i used 15 units TDD and now use 18-20 on average, but that can go up a lot or down quite a bit, even on 130-150 carbs, and little exercise due to other health conditions - if i have lower carbs i use less and if i have higher carbs i use a lot more and control is thrown out for ages, and if i gain even a kg extra weight the same happens - i am middle of normal BMI range. This makes control difficult and now much easier on the pump. But i do have autoimmune disease, C peptide moved from appreciable to very little indeed over 36 years ago, and i now have other autoimmune diseases, there never has been any suggestion i have anything called LADA or 1.5.

 

[ann34+]

Regarding this thread, as far as i understand it from my consultant, autoantibodies are not definitive, even if levels are known, it depends on the type, and there are types within types, however, they do show a susceptibility to autoimmune disease and that these autoantibodies may be mounting some sort of attack on the islet cells, this may be mild or sustained, not sure if there is a way to find out nowadays - however, C peptide levels are an important indicator, as C peptide comes with insulin, no C peptide, no insulin etc. So some C peptide lets you know there is some insulin present - but i am hazy on the how much with your figures, sorry. I have autoantibodies to several other parts of the body, but have developed some diseases and not others. In one case i hav had other antibodies for nearly 25 years suggesting an attack on another area, but, despite being told i would eventually get that disease, i have not yet, and i am still monitored regularly for two conditions. Now being tested for yet another - I try to keep on a strict anti inflammatory diet with no cow products and no gluten, and high olive oil, in an attempt to help matters.
It is interesting that some on the Forum have been diagnosed 1.5 and LADA and manage with no insulin. i am now trying to see if i can take on board some of the ideas here to try to prevent this other possibility