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Help please - freaked out - is GAD indicitive of Type 1?

Thanks mo & Phoenix - I really, massively appreciate your reassurances... Your analogies about water and thinking of it as a necessity really help... I'm so grateful, and might actually sleep tonight, thank you!
 
Re: Help please, freaking out re GAD results

Hi Sunshine_Kisses

The GAD test indicates that there is some auto-immune activity going on in your body - this is common in those with Type 1 diabetes. You do not need both a positive GAD and a positive Islet test to indicate Type 1 diabetes. Please do not get anxious but have the other tests to ensure that you get the best possible care for your diabetes. A high GAD result could indicarte that you have Latent Autoimmune Diabetes in Adults:

"LADA - stands for Latent Autoimmune Diabetes in Adults. It is a type 1 diabetes, which means the body attacks its own insulin producing cells. People with LADA can be diagnosed by having a blood test for antibodies (the chemicals involved in attacking the insulin making cells). People with LADA have a slowly progressing form of type 1 diabetes. This means they do not need insulin when they are diagnosed but will probably need insulin in the future. How soon they will be insulin dependent depends on the level of antibody they have in their blood. Higher levels of antibodies suggest a faster progression to insulin. People with low levels of antibodies are very similar to type 2 diabetes patients. This means they are more likely to be over weight and have some insulin resistance. They are likely to benefit from tablets that act on insulin resistance. People with very high antibody levels are similar to type 1 diabetes. This means they are likely to have acute symptoms (thirst, unexplained weight loss, frequent urination, dry mouth) and are less likely to be overweight. They are likely to need insulin treatment soon after diagnosis"

Let us know how you get on.

Take care

Doug
 
Hi sunshine and welcome,

Take a look in the LADA/1.5 section if you want a little browse as me and a girl call Stacey (aswell as others) are currently In there going through the same thing with GAD etc and have both had babies and gestational diabetes etc etc etc.... at least it will show you ur not alone in this :-)


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.
 
Thank you Elaine!

Well, I don't think I slept at all on Friday night - and yesterday spent the day in a bit of a stupor so just wasn't really able to think about anything at all... today I woke up, had a bit of a cry, then thought - right - I need to do some research...!

My very early findings are that Type 1 diabetes is, very loosely speaking, is either related to genes, food allergies, or viral infections.

My instinct is that, for me, the most likely of the three is food allergies (quite possibly combined with a genetic predispotion - but as I can't alter that bit, I'm trying to focus on the bit I might be able to influence).

My reason for thinking it might be allergy related, is because I had a private test, years ago, with a dietician and it came back that I was allergic to wheat and dairy. I follwowed the advice for years, but in the last 12 months or so I did eat wheat and dairy :roll:

Anyway, the reason theres thought to be an association between the two is: (quote taken from Patrick Holfords 'Say No to Diabetes' book)

"the food allergy link is thought to happen because the immune system can react against a food, producing antibodies that attack it, but it may also mistakenly produce foods that attack the pancreatic cells instead"

To me, given that I seem to have slow onset type 1/LADA/type 1.5, this seems to make sense - as if it were purely genetic or viral, I guess that's when it's sudden... slowly eating foods that are causing a reaction then slowly causes the antibodies to rise. Sounds possible?

Which is a very long winded way of asking if the peeps who have 1.5 diabetes also eat a reasonable amount of dairy?

I ask about dairy, as the two most common food allegens are dairy and wheat.... I eat masses of dairy since going low carb and I wondered if those were staple parts of your diets too?

Hope you don't think I've gone woo woo - just desperately trying to figure out if I can slow down the fact that my GAD antibodies seem to have gone crazy.... And I guess trying to DO something, as otherwise will just sit here and cry... :thumbdown:
 
Re: Help please, freaking out re GAD results

Thank you for your reply Doug, I really, really appreciate it! I'm still very upset about things, but trying to do some reading and research around things - which I just posted a reply about here: (I duplicated the post, apologies - cos I thought I'd probably put it in the wrong place at first...)

viewtopic.php?f=19&t=42369

Thank you again :thumbup:
 
Sunshine,

Cry by all means if it makes you feel better, many of us I think will have done that at some point, But don't beat yourself trying to figure out why......it takes too much energy and it wastes time that could be spent on looking ahead ready to deal with it all. That's my opinion anyway.

I had late onset insulin dependant diabetics in my maternal Grandmother's side. It thankfully so far has 'skipped' my Mum's generation but has opted to get me instead. So of course I went through the 'why me' thoughts and anger. But at the end of the day what's done is done and there's stuff all we can do to change it so the best thing to do is knuckle down and not let it control you.....get on with life, enjoy and remember there's always someone worse off. I just tell folks I'm allergic to sugar but I know at least I can still eat it and with the right dose of insulin may manage to keep good levels whereas someone allergic to nuts or something may end up not breathing and be rushed to hospital......I know which I'd prefer!!

You will be fine and keep asking questions if you are not sure of anything, we are here to help.
Angie
 
Hello Sunshine Kisses.

Another way to feel more on top of your initial fear and feelings , anxiety .
Try writing down a list of all the things you would like to ask -
next time you see your consultant or DSN .
Making your own list - is both a proactive and very positive thing to begin with .
A good place to start at - it will help you get answers and a sense of direction too .
A lot of the HCP's do see this as being very proactive and they will like to answer your questions .

You could take along a family member or a good friend with you for support . :)

Read up on as much information as you feel and need to.
Ask the questions about things you may feel cloudy about .
Knowledge will help to clear the confusion gradually ...
Then as time goes by - you will start to feel your way along etc
Things do start to slot into place and an established routine helps too .

As things begin to make a lot more sense .
The fear and anxiety you are currently feeling will begin to lessen .
Its the unknown - thats the scary bit isnt it ?

As things begin to make more sense gradually you will feel and grow much
stronger about things .
Its a learning curve - and is very much an individual journey with each of us .

The tears are understandable as this has been a shock to your system and is life changing .
Many things will feel beyond comprehension 'intially' .

With insulin therapy it isnt as bad or a failure as one may feeel it to be .
I now know how 'ill' I can feel with too high blood sugars and actually look forward to
the mechanics of insulin working to lower these .
As I do feel so 'much' better for it - it really DOES help change things for the better for me . :thumbup:

Hope this can help you feel more positive and stronger about things .

Anna .
 
Thank you Angie and Anna - some good words of wisdom you've both given which I equally appreciate x

I will write a list to ask my endo consultant when I next see him... although I think he already thinks I'm nuts/a bit high maintenance!! I think he'd just like me to take the meds and go away... if I have to, I will take them - but whilst I'm still (thankfully) in a place where I don't have to take them, exploring other options will give me peace of mind... and at least keep me busy ;0)

Anna, you're totally right about it being scary cos it's unknow! I'd just gotten my head about being type 2, having done *masses* of reading and research around it... I felt I knew what I was dealing with and then - bam - find out that's not what I'm dealing with at all... talk about having the rug pulled out from under you! :(

A friend of mine said I shouldn't put anything on being 1 or 2 as they're both the same - but to me that's a bit bonkers - especailly as I thought I was dealing with early diagnosed and 'mild' type 2; so to me, in my (then thought) situation, it's a little like saying a kidney infection and kidney failure are the same! Yes, both involve the kidneys, but one means your kidney is likely to recover and the other means it's likely to not - which are totally different kettles of fish to me... but apprecaiate I may be feeling a wee bit sensitive at the mo :oops:

Anyway, I'm still reading loads and finding out interesting possibilities - Angie I hear what you're saying and it may be futile, but I have to have something to focus on at this point to stop me getting very anxious and distressed about it all. I guess it's just my coping mechanism... anyway, will post a bit more about what I've read in the LADA section....

Thanks again for your words of encouragement - they're helping to keep me sane! :thumbup:
 
Hey Sunshine!

A positive GAD test is usually indicative of an autoimmune form of diabetes - for you, that probably means LADA. Eventually, you will have to inject insulin. I was originally misdiagnosed as Type 2 but I was reclassified as Type 1 (LADA) following a positive GAD test. I went straight onto insulin. I cried a lot at first, thinking it was the end of the world. It isn't. You get used to it very quickly and it just becomes part of life. You'll be OK!

Take care

Smidge
 
Re: Help please, freaking out re GAD results

Hi. Having the GAD result may not be what you wanted but is a useful early warning that your diabetes may progress rapidly. Your HBa1C of 7.5 means you do need some medication already assuming you are already low-carbing. May be you can be started on one or two of the diabetes tablets, but I think you should assume that your blood sugar may continue to rise to the point that insulin is needed; sorry.
 
Hi Again,

More help please! Had a day of being bumped from pilar to post between my GP surgery and my Endocrinologists office and now my head hurts... :(

Following on from the GAD result on Friday, my GP told me to contact my Endo to find out more... today managed to speak to Endo's secretary, who told me I need to discuss the result with my GP - as I can't see the Endo til August, but he'd written to my GP advising what to do next... Went back to my GP to ask what was in the letter - and they've printed it off for me. This is what is says:

"Following on from my last clinic letter, this lady's fasting blood glucose performed on April 23rd was 6.3mmol/l which is within the impaired fasting hyperglycaemia range.

I will therefore arrange for her to have an oral glucose tolerance test. It is important to exclude Diabetes on that test as her GAD antibodies are elevated at 1682. I will write to you once we have the results of these tests"

I asked my GP whether this means I am type 1 or type 2, and she said she can't say - that the Endo has to decide that. I then asked whether they are questioning whether I *am* diabetic now - as the wording of that to me seems to imply they are - and again she said she can't say...! Very, very frustrating - does any one have any thoughts?? My last hba1c was 7.5, but that was back in mid-feb... I have dramatically cut back on carbs since then, and with my meter blood sugars are usually between 5 and 7, and always drop back to those numbers 2 hrs after eating.... I am *totally* confused now as to what the hell is going on, and pretty stressed out too as god knows when they will do this fasting glucose, not to mention that I'm not seeing Endo for another three months!

Does it sound like they're questioning whether I have diabetes to you, or are they just trying to figure out which one I have? What will an oral glucose test tell us?

Help/thoughts very much appreciated...
 
These really are thoughts, none of us including it seems your GP can second guess the specialist.

My first thought is that the OGTT is to discover whether you are at diabetic levels at the end of the test. If that was the case you would already have diabetes and not 'just' impaired fasting glucose . If this was the case then the action he suggests may be different.

My second thought I dismissed but will still put it. There are other conditions that are associated with GAD antibodies . I dismissed it because it seems to me that these other conditions would all have some other symptoms . You already have impaired fasting glucose so looking at the simplest reason seems the most reasonable.

By the way to get an accurate OGTT you should be eating 150g carbs minimum during the 3 days before the test.
This page is from Australia, I looked for one to confirm the 150g carbs . When I found this one, I noticed that the flow chart on the page definitely suggests that someone with your levels should have an OGTT to exclude/confirm whether you have diabetes.
http://www.racgp.org.au/afp/2012/june/o ... e-testing/
 
Thanks so much for your thoughts Phoenix - I apprecaite you saying they're just your thoughts, but at this stage that's a lot more than I'm getting from my GP or consultant!

I'm frustrated they want to do the OGTT - prior to getting diagnosed, and even for the first 2 months or so post diagnosis, my fasting blood sugars were above 6.9 (usually 8, sometimes 12!) and my random blood sugars were anything between 7 and 15... the only reason that they're in a 'nice' (or impaired) range now is because it took them two months after my diagnosis to take an official fasting glucose and by that point I'd been low carbing at less the 50g a day and exercising like mad! My blood sugars are now in a pretty good range, but that's because of what I'm eating / doing (I'm now about 30g carbs a day) - which I've worked really hard at. To my mind, the OGTT is completely pointless and will put unnecessary stress on my system - do I have to have it?

Please, do let me know if I'm missing an obvious reason to have it... I would never disagree with a dr if I thought it was negligent to my health, but I feel what he's recommending is actually more negligent, and totally unnecessary if he just had a conversation with me :(
 
PS - I guess what I'm asking in a waffly kind of way is, given that I know my blood sugars will go out of range if I eat carbs, is there any real need for me to have the OGTT? I'm stressing that it will undo my good efforts and kill more cells :( :(
 
Hey sunshine,

My opinion is yes just do it... You're right when you say that you know it's not good for you and will push ur BS up but unless the doctors see proof for themselves it will stop you getting a proper diagnosis and long term care for your condition... It's like when you're pregnant and you take a home test...before they assign you a midwife they make you hand a sample to them to verify.... From what YOU have said your levels are a lot worse than the docs currently think they are when you are eating a normal amount of carbs and they need to see this so I would, as mentioned above, eat normal carbs the week of this next test and let them see the damage! As soon as its over you can switch back and a few days of high BS won't have any long term effects I wouldn't think because whenever we are stressed or have a cold etc. they do climb for a few days usually anyway.

Also, I don't know if this is helpful to you but my GAD result back in December was 329 so yours does seem very high and I have already started to see a slight rise is my BS over the last 3 days but I'm not sure whether that has anything to do with the weather being so hot? Or the fact I haven't been as tight with my diet as I was being...though I still haven't had my beans on toast that I so badly want :-(


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.
 
Hi Elaine,
Thanks for your thoughts - and I do see your point - but still think its ridiculous they want to do it... Surely there's another way? Isn't there some sort of test they can do to see how much insulin I'm producing...? :-(

Aside from said test, assuming I did it, and failed, then what? Am I then going to be told I'm type 1.5? Are they planing on waiting till August to tell me this??

Sorry, not expecting you guys to have all the answers - just sooooo frustrated -keep thinking 'right, I know what I'm dealing with now' and then the goal posts move. If I knew whether it was 1, 1.5, or 2 then I could start to 'cope' with it - not knowing what I'm dealing with just makes things really awful :((
 
The only test you haven't had that I have had is the c-peptide test which is the test that gives a rough idea of how much insulin you are producing. Mine was at the bottom end of the normal range back in December (normal range I was told was 360 - 1400 and I was coming in at 395).

I didn't have to do an oral glucose test because my fasting was 9.7 mmol at the time of diagnosis which, along with a low c-peptide and a high GAD result, allows me to be diagnosed as a clear type1.5/LADA. My guess is that because your fasting wasn't too terrible the first time round they are trying to test your PP to actually establish whether you have diabetes but to be honest with a GAD level as high as you said yours was I would be surprised if it wasn't type 1.5/LADA.

What are your fasting BGs like now? If they are in diabetic range you could probably ask them to give you another fasting test so you don't have to bump up ur carbs?

And yes, they probably are expecting you to wait til then for your results, i had my blood took a couple weeks ago for my next consultant appointment next week which will be the first time ive seen him in 4 months! That being said you maye able to ring up for your results earlier if you want them.

The thing that confuses me is that EVERYTHING I have researched says that the PP levels are the first to deteriorate in type 1/1.5 diabetes and your fasting is the last to go as you hold onto your base insulin production for longer but...that's never been the case with me! My fasting has always been terrible no matter what I do or eat before bed.....so I'm just as confused about my diabetes too lol!


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.
 
Actually wait a minute...what am I talking about? An oral glucose test doesn't require you to bump up ur carbs? I've always thought an oral glucose test is where they test your blood then make you drink a really sugary liquid then test you again two hours later to measure ur PP levels! U can do it at home with lucozade! If it is what I think it is then dont worry you can keep your carbs right down, carbs would only effect a fasting blood test or a test after eating a low carb meal not a OGTT I must've been thinking of something else entirely when I answered you earlier! It must be the lack of beans on toast haha!

Don't worry about this test it's the best thing to do as it will have minimal effect on ur BS literally just a couple hours worth of high levels and at least then ul get a proper diagnosis. Maybe ask for the c-peptide too if its worrying you :-)


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.
 
Thanks Elaine, really appreciate it - I'm still not sure about the OGTT (which, yes, is a ridiculously sugary drink!) as I know it will really mess up my blood sugars... I 'accidentally' (aka slipped up!) and had a very, very sweet piece of cake recently (it was gluten free - I think they'd replaced the flour with sugar!!) and it took me two weeks to get my blood sugars - my fasting blood sugar especially - back to where it was pre cake! So that's why I'm so resistant to having it done, as I know how hard I'll have to work to get them back and especially as its not going to tell me anything I don't know!

My fasting blood sugars are currently in the late 5s - but that's only because I'm so low carb... If I go above about 50g of carbs and 1,200 calories, then it would be in the 8s... If I ate 'normally' ie 200g plus carbs a day, it would be well into double figures... I already know all this from my meter, I don't need a sugary drink to tell me - but if they currently did a fasting glucose or they looked at my pp readings I would show up as non-diabetic... I'm just frustrated cos if they actually *talked* to me (whoa, crazy idea?!) then we could move forwards... :-(
 
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