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Test results positive antibodies

R

Rose22

Well-Known Member
Messages
282
Type of diabetes
Type 1
Treatment type
Insulin
Hello, I have posted before when was first told I’m making insulin but positive antibodies, by the consultant on the phone. Left me a bit confused. I emailed and asked for the test results please to be sent to me. What I’m wondering then is from these results am I perhaps LADA? Currently type 2 as had gestational twice, then prediabetic kept it there 2 years then sugars rose and rose despite my best efforts. I queried type 2 diagnosis as normal blood pressure, normal cholesterol, and only slighly over weight bmi 26, since then lost 6kg so I’d say good weight now. Only in my 30s and family history of diabetes type 1 and type 2. They referred me finally after trying 6 meds over a year and then consultant wondered if I was MODY, I called up to chase up test results and see if going to test for MODY and he said I was positive antibody and doesn’t think worthwhile MODY test now.

Results are in! They have sent me across my test results...
ANTI GAD 1083. U/ml 0-4.
Anti Gad Antibody = positive.

ISLET CELL 20.
Pancreatic islet cell antibody = positive.

Cpeptide 1311 pml/L
Fasting glucose 9.7 mml/L. 3-6.

This is how it is written on the sheet.
They had told me I was positive for some antibodies seen in Type 1.
 
Hi. If I understand your C-Peptide results correctly, that level is quite high and implies currently T2 and a high insulin production level? Now C-Peptide results can be very confusing as everyone uses different units and different abbreviations so I could be wrong. It is possible to start by being T2 but with positive GAD antibodies lurking which can become active and then convert you to a T1 by destroying your beta cells. Might be worth discussing the C-Peptide results with the doc.
 
I recently had a positive GAD too with 1700 antibodies. They said the C peptide was normal. Have been referred to an endocrinologist. GP said it could be 6 weeks plus. I have been low carbing. Hba1c was 96 mmol in Jan when diagnosed with type 2. Went down to 72, then 52, then 56. Now 45 mmol last week. Was shocked finally cracked the hba1c now recently told possible LADA. I am also ok BMI at 25, 44 years of age and active. I had gestational diabetes too with both of my boys 12/13 years ago.
 
In the early days of LADA your C-Peptide can be normal and it can be very confusing. Tablets and a low-carb will work for a while but over the years (or months) it will progress leading eventually to insulin if you are LADA. GPs find all this very difficult to cope with unless they are well trained. At least you are being referred.
 
 
It is confusing. Do you think I may avoid insulin in the first place with a hba1c of 45mmol as my latest one? It’s taken a year of LCHF to get to this. I was very pleased. It’s a shame I have LADA. I’m sure I could keep it here if type 2. If c peptide is normal, then it means I still produce some insulin then ? If I do I am guessing insulin injections could be avoided for now? I’m still on metformin. Is that of benefit? I’m guessing so.
 
So is it possible I don’t have LADA? GP said antibody test was highly positive with result of 1700, characteristic of type 1. How would you know if you have LADA for sure? Does endocrinologist do more tests?
 
Nice to see there are other people in same situation! It is confusing isn’t it. The consultant said to me on the phone that they don’t do mody test as had thought I was that as very sensitive to drugs. Then said my results showed positive antibodies that type 1 have. I had asked for this 2 years ago as I suspected it would be the case as I tried so hard diet change exercise and all the meds they told me to take, and my sugar levels go up anyways! If I don’t take anything I run up to 24.9 which makes me feel unwell! So now thinking LADA, and consultant said to me If I get unwell an infection etc start loosing weight fast then need to contact them as may need insulin. I think it’s probably a case of wait and see..one day might not produce enough insulin any more.
Massive well done for your latest hba1c! That’s brilliant level isn’t it! You should be so happy with that, amazing! Mines stuck at 68. Hoping the next one is lower as will have done 3 months on repaglinide then, which makes me produce insulin when I eat.
 
Millie74 said:
So is it possible I don’t have LADA? GP said antibody test was highly positive with result of 1700, characteristic of type 1. How would you know if you have LADA for sure? Does endocrinologist do more tests?
Click to expand...
Thankyou this makes sense.
 
Hi. Some people have positive antibodies and can go thru life with either no diabetes or with insulin production at a normal level. It appears that in some cases the antibodies aren't active. The so-called honeymoon period can last many years so only time will tell whether you will progress on to needing insulin. Metformin is always a good start. I then went on to Gliclazide which stimulates the beta cells. I ended up on full dose (320mg) at which point the GP should have started me on insulin but didn't. The fact that this max dose no longer worked showed that my beta cells were largely gone. I wasn't started until my HBa1C was over 8%, too late, and I had to severely control the carbs. So, keep an eye on your HBA1C.
 
Thankyou that is really useful information. I will watch my hba1c, so far despite meds it’s gone up. 3 months on Gliclazide kept it at the same level but not down. I’m hoping it’s going to be down on the next test in few months.
 
Thanks all. It’s very confusing. As I said, just on the metformin 2000mg at moment. So it’s possible to have the antibodies and that they are not active yet? My high on carbohydrates are 10-13. Mainly porridge or bran. I try to have under 50g carb a day now though and avoid porridge/ bran. This is how hba1c is down after 1 year of trying. I am very pleased with hba1c. But realise could all go up again. I thought they avoided additional tablets if you had LADA/ 1.5 or slow onset type 1 and the preferred treatment was insulin? I think I would have hypo issues if started insulin now. I teach dance and after a few classes it’s down to 5.0.

Will be interesting to see what endocrinologist says. My aim is to keep trying with low carb for the moment. Having the livlife low carb bread for breakfast or egg muffins as much as I can now. Shame as love porridge and bran!
 
 
I am over the moon with last hba1c. Taken a year though going lower carb. Only had 20/30g carb in last few months. I do get highs if eat carbs! I wonder when the good hba1cs will end though. Like many say, a waiting game. 68 isn’t too bad. As I said I was 96,72, 52, 56
 
Hi. Yes, the argument about avoiding tablets such as Gliclazide when LADA is that it stimulates the beta cells and some feel it can burn them out; the evidence varies. I was on full dose for several years and wonder what harm if any it did. I would always recommend anyone to press for early insulin if LADA is suspected or obvious. You can just start with a low dose of Basal insulin adding Bolus later. You can keep the dose low enough to avoid hypos although it does involve several tests each day and 4 to 5 injections. GPs vary radically on the subject. My GP said (wrongly) that insulin was a last resort whereas others do start it very early. Keeping the carbs way down will always help but there comes point when insulin will enable a better quality of life.
 
.[/QUOTE]
Your c-peptide of 1311 pmol/Lwould support type 2. It should be less than 200 pmol/l on diagnosis for type 1. GAD antibodies need to be destroying your islet cells for you to be type 1, which they aren't by your level which suggests insulin resistance. GAD antibodies can exist in the general population without causing type 1. They are linked to another autoimmune diseases. Ask for a referral to an endocrinologist to be sure.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446389/
 
Last edited:
ert said:
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Click to expand...
Your c-peptide of 1311 pmol/Lwould support type 2. It should be less than 200 pmol/l on diagnosis for type 1. GAD antibodies need to be destroying your islet cells for you to be type 1, which they aren't by your level which suggests insulin resistance. GAD antibodies can exist in the general population without causing type 1. They are linked to another autoimmune diseases. Ask for a referral to an endocrinologist to be sure.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446389/[/QUOTE]
Ah ok Thankyou that’s interesting. I have had consultant letter today that he has sent to my gp. No talk of LADA or type 1 or type 2. He says “interestingly her anti gad antibodies have come back strongly positive at 1083. With a normal range 0-4. And she has positive islet cell antibodies of 20. She does however have a high cpeptide.”
He’s saying with the anti gad there’s a risk I may develop type 1, and if I become very unwell to contact them to assess whether insulin is then needed.
So I think for now, it’s carry on and see, exercise; eat well avoid starchy carbs. See specialist diabetes nurse in January so will see what she says about it all.
Thanks for all the useful advice and info! Has really helped, otherwise I do like to worry hehe!
 
Hi Rose, it's perfectly acceptable to worry about your health! Your story is very interesting, positive for more than 1 antibody, normal range of C Peptide etc, just goes to show there are so many variations and opinions. With the bit about 'if you become unwell', please don't forget to keep up with your testing, things like DKA can creep up on you even whilst you are feeling well. Just before diagnosis I was feeling great (apart from weeing a lot and losing weight) but after various tests they realised I was virtually going into DKA (all the tests were screaming warning signs) and yet I felt fine. They kept me in hospital for 24 hours where I was moaning like a good 'un because I felt so well and didn't want to go on a drip but they said with DKA it can come on literally within minutes and your body can shut down within minutes too. Time can be of the essence so if you're at home you might not feel any symptoms. x
 
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