Anti GAD antibodies

Hi all, I had gestational diabetes with a previous pregnancy (daughter is almost 2) and was on insulin despite following Bernstein’s diet as close as I could, averaging 50 g cho day.
I have an astute GP who did some metabolic testing after pregnancy and I am not insulin dependent but did have anti GAD antibodies. As I recall, >5 was positive and mine were in The 100-200 range. She suggested trying gluten free and rechecking in 6 months to see if gluten is an autoimmune trigger for me. I was not insulin resistant but may be somewhat when pregnant. Fructosamine was slightly elevated. HB A 1c averages 5.4 and I am on no other treatment. Fasting is about 105 and I am not having elevated post prandial at this time.
I am currently 8 weeks pregnant. I am expecting gestational diabetes again, but the gluten free is very hard right now as I am having major all day nausea and food aversions.
I know if gluten free helps forestall a major disease like diabetes it is worth it.
Anyone else have or know of similar situation? I am having my antibodies rechecked soon, so will be able to update whether it seemed to help early autoimmune diabetes.

Hi Catvet: I have never heard that eating gluten-free slows or stalls the immune-mediated destruction of the beta cells that is Type 1 diabetes, and I have never read any scientific papers that state that. I wrote a blog about autoimmune gestational diabetes that you may find interesting and useful. I also wrote a blog on autoantibody testing. With Type 1 diabetes/autoimmune gestational diabetes, insulin is a necessity. Low carb is helpful, but insulin is the treatment for autoimmune diabetes.

There are quite a few women here on TuDiabetes who had autoimmune gestational diabetes. I hope some of them will give you advice!

It’s interesting to me that your lab called >5 on the GAD test to be positive. The lab my tests got sent to called positive >1. Mine was 3.6. This is going to prompt me to dig a little deaper on that subject with my doctor.

Catvet, you're fortunate that you have an astute GP who did some metabolic testing. While it would be reasonable to postulate that gluten may trigger autoimmune responses, it does not appear that there are any scholarly research on gluten triggered auto immune except what I found here: I cannot vouch for the reliability of this org or the doctor. I just began to skim through Wheat Belly by William Davis. Our bodies are all different. Gluten sensitivity and intolerance may be technically different from the medical test definition of celiac.


Your doctor should not just tell you to give up gluten on a whim! While true that type 1 and celiac can be linked (both are autoimmune diseases), it just affects about 10% of diabetics who have type 1.

Your doctor should order a celiac blood panel. Go to the University of Chicago’s celiac website for testing requirements. You need to be consuming gluten though until all testing is complete. If positive an endoscopy is typically ordered.

How long have you been gluten free? This will cause a negative result.

There are over 300 symptoms related to celiac disease. Some folks do not have any symptoms at all! Strict adherence from gluten is required and cross contamination is a big problem for celiacs. You can seriously get " glutened" from just kissing your spouse or a sweet slobbery toddler.

I wish you well!

Hi Cycling Lady. I have had other testing for celiac, which I do not have and my doctor didn’t suspect, either. I do have other auto immune diseases, though and some people believe gluten can just be an autoimmune “driver” in some people. I would prefer not to eat GF, though, but being diabetic you can’t eat everything you want all the time either! I will keep everyone posted as I am having my anti GAD antibodies retested. If they did come down, I will have a decision to make about continuing GF, but it seems like a no brainier if it works and keeps me off insulin.

Okay, as long as they took a complete panel and I assume that they did since you have other autoimmune issues. It is just that it is hard to stick to the diet (cross contamination is difficult outside your home) if you do not have a diagnosis.

I also have never read that a GF diet could save your beta cells or prevent another autoimmune disorder from developing. But there is controversy regarding Non-Celiac Gluten Intolerance. I think that by trying not to stress your pancreas by eating to your meter may help. Experiment with the foods you eat and avoid those that cause spikes. Adding insulin may help.

Congrats on your pregnancy and wish you well!

Thanks, Cycling lady! I think I wasn’t clear. I figure I WILL be on insulin eventually during this pregnancy, the unanswered question is whether ANYTHING prevents or delays autoimmune diabetes once antibodies are formed.

There are some clinical trials going on that you may want to look into, but I think you would not be eligible for them while pregnant — still, they could give you some ideas for further research. Take a look on TRIALNet for LADA trials — because it sounds to me like that's your most likely diagnosis in the long run.

In general, given that autoimmune diseases represent hyperactivity of T cells and a failure of the immune system to distinguish self from non-self, about the only thing you can do to forestall autoimmune diabetes is to limit exposure to anything that might trigger your immune system to light a fire. If you have any indication of sensitivity to gluten (even though not celiac), then stay away from it, just to avoid stirring up your immune system. Ditto the other foods that tend to be allergens — dairy, egg, peanut/tree nut, and so forth. You've had an antibody panel, but have you had extensive allergen testing? If not... that might be the next step, so you know what foods to limit. The quieter you keep your immune system, the less likely it is to decide to attack your pancreas. It won't stop it from happening if it's going to happen, but it might help put off the time when it does happen.

Also... don't get sick. (I know, I know... easier said than done!) Regular, consistent handwashing is probably your best friend right now.

But doesn't it depend upon the lab and the specific test and measurement units they are using? I just looked back at my original test and the standard range was listed as 0 to 0.02 at nmol/L with a reference range as <=0.02, so a result >0.02 would be indicative of elevated GAD under that test.

EDIT to add the test shows it was performed at the Mayo Clinic Dept. of Laboratory Medicine & Pathology.

yes, I had the same test at the Mayo clinic and it is measured in nmol/L. I think the test showing greater than 5 is likely measured in different units.

Just looked at mine which was “U/ml” which I had never heard of bit I think implies they standardized some sort of unit specifically for the test range

"Also... don't get sick. (I know, I know... easier said than done!) Regular, consistent handwashing is probably your best friend right now".

I'm curious how getting sick would affect the progression. Particularity now since I've picked up a nasty respiratory infection from School- where I work. Are you talking about a major illness or is there research out there that states a regular everyday virus could have an impact ?

There is some thing that causes the immune-mediated destruction of the beta cells to begin (combination of genetics and environment, perhaps an enterovirus) but then there is the trigger that pushes a person over into overt Type 1 diabetes. My trigger was two severe colds back-to-back, but the autoimmune process had probably begun long before, probably years. So if you get sick, and the immune-mediated destruction of the beta cells is already underway (evidenced by detectable autoantibodies), the illness raises your blood sugar but your beta cells can no longer compensate. And over the edge you go.

It's interesting to consider what pushes us over the edge. My T1 showed up a few months after my dad died. I was eating huge amounts of comfort carbs and my poor pancreas could no longer keep up. I think situations like mine are what cause some people to mistakenly conclude it's the emotional event that caused the T1 when that's probably not really the case.

Ok, this is a follow up to my original post. I just got my new bloodwork. Upon my doctor’s suggestion, I have been gluten free 5 months. My anti GAD antibodies were unchanged. The little kid in me is gleeful at not needing to be gluten free. The mature part of me is very disappointed as it would be so gratifying to tell mainstream medicine that there is something to do to forestall this disease. Whatever drives my immune system, gluten is not it. However, it may be for someone else. I think we should all continue to be proactive, follow up on what might be workng and who knows, we may discover something before mainstream.

Glad to hear that it was not gluten (but I did not think it was). My thyroid antibodies have not declined despite my being gluten free. So, I would not think that GAD antibodies would decline either. However, my antibodies for celiac have declined dramatically since going gluten free.

Thanks cycling lady. Let’s keep this going. Has anyone in the honeymoon period had their antibodies decline? Average onset ranges from 2-12 years to overt diabetes from onset antibodies.

Hi cadvet!! I had gestational diabetes. I was 28 years old. They did not do GAD testing then. Four years ago, I was dxd with type 1 slow onset at age 50. There are times I wish I knew that I was going to be dxd with this, but I was always healthy eater/lots of exercise, so really don’t know what more I could have done if I had known? Maybe it was better not knowing… Who knows!!! They were going to prescribe insulin when I was 7 months pregnant, but went into labor…they said diabetes could cause early labor and big baby. And he was for being early!!!

Hi PA3305. You had a really long honeymoon before your full diabetes. As I a, 44, I would anticipate a shorter course, but who knows? It is interesting to read about the differences and look for similarities.