Hi Everyone,
Thought I’s share my c-pep results with you and see what the consensus is?
Endo states Type 2 but not rulled out slow onset type 1. What does everyone think? Oh negative GAD Antibody test.
Thanks,
JD
The C-peptide level sounds good for now. It’s good that your doctor will keep watching for changes. If you have slow onset type 1, then there would be a downward trend in the c-peptide over time (I suspect). But your doctors reaction seems very reasonable (but I don’t know a lot about this!)
Perhaps some people with LADA can report how they were diagnosed!
Thanks Kristin I guess only time will tell.
Was your test fasting, or post prandial? Do you have your lab’s reference range? these are things you really need to know to interpret your test.
I was dxed Type 1 at 29, and my first c-peptide that I know about was .8 ng with a fasting of 179. Ref. range is 1.1 - 4 ng for fasting. I thought maybe since I was already on insulin, that it would affect the test, but the endo told me that it wouldn’t. Before I went on the pump, they did a new c-peptide and it was “immeasurable” but I don’t know what that would translate to in actual numbers. Not sure if this helps.
There are more antibodies than just GAD. Is that all they tested?
Hi Mandy,
Since I had some basal insulin in the morning they had me drink some juice and my glucose was 197 at the time of the test 4:30 in the afternoon. This should mean I would have a good amount of C-pep in my system from insulin production for the juice. 1.45 was at the low end of the range 1.10 - 3.20 ng/ml. My history 2003 lost 15-20 in a month and a half with an A1c of 14.2. 1st Endo put me on Metformin and Glipizide in a 3 months time I went down to 6.1 with a very restrictive diet maybe 60 carbs a day. I’ve been slowly climbing ever since Actos etc added but I’m now 9.0 A1c as of Oct…6 or so years. Changed Endo’s because the last one put me on 70/30 novolog 2 times a day and said 200 was an acceptable BS. At age 41 I don’t think this was aggressive enough, so I went to Joslin in Boston now on Basal Bolus and doing much better. IA2 -0.050L range .000-.099, Insulin Antibodies -2.0L Range 0.0-39.0nIU/mL. LDL calculated 100 Sounds like Type 2 but with the C-Pep so low could be Idiopathic type 1b?
Regards,
John
Do you know about LADA? Sounds like it might fit your situation… It is also referred to as Type 1.5 (just as a warning some doctors don’t think it exists, and just call it slow onset type 1).
We have many members who have LADA that were accidentally diagnosed with type 2.
Okay-
I think you are a type 2. What I think is happening is that you used to be making insulin but had some degree of insulin resistance. That is why you initially responded to the drugs. The lower carb diet was probably good for you, too, since it was resting the beta cells- if they have to produce less insulin, it’s easier on them. The problem with beta cells is that they aren’t that robust, and if you stress them enough (often the case with type 2s, who are having to produce and release large large amounts of insulin to maintain glycemic control) they will just die off and while the drugs keep you more sensitive to the insulin you are making, you stop making enough for your needs, and now you need additional insulin (like the stuff you are taking).
This doesn’t make you into a type 1- some people confuse this. Additionally, LADA stands for latent autoimmune diabetes of adulthood. LADA is still an autoimmune disorder (which is why they tested you for antibodies). Given that your antibody tests were normal (if you had been truely autoimmune they would be off the charts) and that your c-peptide test is still in the normal range, I conclude type 2.
Hi Lane,
How about Idiopathic type 1b only 70-80% of LADA’s test for antibodies the rest are negative. Sounds out there but possible? I found this explaining 1b I’ve also had moderate Ketones twice in the last week forgetting to take my shot not typical of type 2.
(Type 1 B diabetes is also referred to as idiopathic diabetes, or diabetes of unknown origin. This form of type 1 diabetes is not autoimmune in nature, and tests for islet cell antibodies will come up negative. People with type 1 B have an insulin deficiency and can experience ketoacidosis (a high blood sugar emergency), but their need for insulin injections typically waxes and wanes over time.)
Regards,
John
Hey John,
I still think you are most likely LADA. Are you a minority? I ask because idiopathic diabetes is mainly in the Asian and African American populations. Also, the oral meds may have worked if you had some insulin resistance, but even type 1s can have that. Also, there are about 20% of people with true Type 1,who DON’T HAVE ANTIBODIES. The assays are not the most reliable test, and they believe the disease might be a disease of flares and remissions, so antibodies are only present at the time of attack. IMHO
Hi Mandy,
I did read that it is mainly minority related and no I not a minority. Flares and remissions interesting I haven’t seen anything on that. I meet with my New Endo for the second time next month. I’ll come back and post what we discussed. I know the treatment is the same no matter how you look at it… but its one of those things you need to know. Plus I would like to go on a pump and with a low C-Pep and Type 2 classification insurance probably won’t cover it. I’ve learned so much here thank you to everyone!
JMD