HbA1c down to 5.6, but high antibody count

Hello Everybody,

this is just a personal update on my diabetes numbers. For the first time since diagnosed I had my HbA1c tested and have gone down from 7.5 to 5.6.
To be honest I expected it to be even a little lower from the numbers I had been seeing on my metre, but I guess it is still reason to be happy for now. I am still in my honeymoon period though, so I guess I can only partially take credit, and have to give my slow-coatch pancreas some too. (Although I dont really feel he deserves praise, we re still not on such good terms ;)

The "bad" news I got from my endo was that when I had my initial antibody test, I actually testes positive for both GADs and ICAs, where for som reason I thought i was "only" GAD positive. And the GADs had a high count (69), where apparently 1.1 is the limit for "normal. Seems very high to me, but I cant really interpret the numbers.
I did ask my endo about it, he went all waffly on me, but I gathered that it does mean that the beta cells will come to total defeat quite a bit faster than I had hoped for.. I had sort of hoped, since I was "diagnosed early" with a HbA1 of only 7,5, that it would maybe mean I d have a few more years of a bit of pancreatic support. Oh well.
Does anybody know more about the relationship antibodies – decline of beta cells? I know, I know, its all about diabetes management and I shouldnt focus so much on oracling about the demise, but I guess I cant help it...

Anyhow, just wanted to share my news with the people who understand best.

HaPpY ChRiStMas to everybody now!!

You have done really, really well. An HbA1c of 5.6% is great, many here would kill for that and you need to realize, that is within the range that most of the medical professional considers "normal." As to you antibodies, you already tested positive, any further readings really don't matter. The studies I have seen have not been able to find a correlation between antibodies and the progression of the diabetes. I could probably dig up a few papers if you want. In either case, have a Merry Christmas.

I agree with Brian, both on the ***Great Job!!!*** w/ the A1C and getting your BG under control and on the "it doesn't really matter" about the antibodies or prolonging endogenous insulin production. It's obviously extremely beneficial to have the correct T1/LADA/T2/ etc. diagnosis as soon as possible but I'm very skeptical that there's a big advantage to "homegrown" vs injected insulin as I think the most important part once you're diagnosed is your BG which, if your A1C is 5.6, you are controlling.

On it's own 5.6% A1c is excellent. But achieving that reduction in just 6 months and on injections is outstanding. A reduction of 1.9% is enormous. I wouldn't worry about medical parameters such as GAD that you have no power to modify. You have already reduced your chances of long term complications significantly. What better Christmas present could you wish for?

Congratulations on the outstanding A1c. Even after 6 years, I think I'm still getting some help from my pancreas although sometimes I'm not so sure. You're never going to be able to tell whether its those few tough beta cells or your self-discipline or just plain dumb luck that enables you to maintain very good control. Since its better to be lucky than smart, why not just chalk it up to luck and keep plugging.

Have a wonderful Christmas and may the year to come bring you everything you wish for,


Hi Julez: Congrats on your great success in lowering your A1c! That is really something to celebrate.

In Type 1 TrialNet, relatives of Type 1s were tested for antibodies and followed, and those who had more antibodies and higher titers developed Type 1 diabetes earlier than those with fewer antibodies and lower titers. Researchers have surmised that this means the autoimmune attack is more severe/faster in those with more antibodies/higher titers.

The key for you is maintaining tight control, which has been shown to preserve remnant beta cell function. You are doing great!

My understanding is that antibody "levels" are not particularly useful in either screening or in tracking progression of T1/LADA diabetes. Some of the things I have seen suggest that GAD positive patients progress to insulin on average in 6 years, but GAD positive and ICA positive patients progress faster. But I think it is just too complicated so most practitioners think that tracking c-peptide and hyperglycemia gives a better indication of progress.

I found a graph that I think explains this theory pretty well. It is part of "Diabetes Melitus: A fundamental and Clinical Text, 3rd Edition" (2004)(chapter 31): http://www.msdlatinamerica.com/diabetes/index.html.

The graph I was citing is here: http://www.msdlatinamerica.com/diabetes/files/491c9d398f32b2ade98a2.... The graph is vauge in terms of length of time, but this is the general premise of the Type 1 Diabetes Trialnet research where researchers test close relative of a Type 1 for specific auto-antibodies.

Further, this graph (http://ars.els-cdn.com/content/image/1-s2.0-S0091674909015395-gr4.jpg) shows how long individuals took to progress onto actually T1D. 2 auto-antibodies took 7-10 years for half the participants to be diagnosed while the other autoantibody was only losely directly related to T1D. I would agree with BSC: Having these specific auto-antibodies greatly increses your chances of developing T1D, but it is poorly understood as to how, when or what concentration.

All true. Also, I think I was mixing up TrialNet and DPT-1 (Diabetes Prevention Trial-Type 1). I should always check my references before writing :)

It's interesting how some identify an event a week or two before diagnosis as being the "cause", yet the research studies show antibodies going back 6 to 10 years.

I too am I LADA Type 1 who is still "honeymooning" some, but my doctors have told me that it will almost be easier to manage my diabetes once my pancreas totally goes kaput. I'm assuming this is because I will be in total control of the amount of insulin in my body. Which I agree, is sort of a double edged sword. Part of me wants my crippling pancreas to hang in there as long as it can and help me out, but the other part of me is just ready for it to be done with so I can handle it from here.

Congratulations on your HbA1c!! That's awesome. I was a 9.2 when diagnosed almost 3 months ago and just had one done this morning. I find out what the results are in a few days, I'm very anxious..

I'm with you on that one. I always wonder when people talk about preserving beta cells. It does seem like it would be simpler just to manage without them since they're leaving sooner or later anyway!

For me the insurance difference between being a T2 and a T1 are huge. Being diagnosed with T1 via GAD antibodies and other factors made it easy to get a pump, whereas my insurance would have fought against it.