Pancreatic islet cell ab

Okay so we all know my GAD-65 was positive, but my PANCREATIC ISLET CELL AB, SERUM, QUAL NEGATIVE. So I am ICA negative I find this odd?

Why is that odd? Most people only test positive for one antibody (and from what I can deduce, the vast majority of those positive readings are the GAD-65). I only tested positive for one of the 3 antibodies on my screening.

I thought the GAD65 was the only one they expect to be positive for LADA’s. Oddly enough, I’ve never done my antibodies. When it mattered and I was struggling to identify my type I was in Guatemala where they had no clue about GAD tests. By the time I returned to the states I was so sure of my type there no longer seemed a point to it.

True to both of you. I do have an appointment with a second endo since my current endo,even though GAD positive will not id me as type one. I will keep you posted with my other endo. I am having a terriable time this week. My sugars are 311 to 192 to 280 and I have increased my bolus ratio and my basal I’m getting frusterated and I just want to be in denial. I guess with LADA you just have to roll with the punches huh? My fasting this morning was 188 this is the second week I have been all over, is this normal?

I do not have LADA, but according to this page LADAs usually have GAD antibodies, and it’s the more classic faster-onset Type 1 that tends to have all the rest.

It can be, Stardust. I think two things: It takes awhile to get it all figured out for your needs: I:C ratios, basal doses and times, what you eat, etc. Just keep really good records by whatever means works best for you to get a clear look at patterns. I’m a paper girl and I use a notebook where each page is like 3-4 weeks. I write carbs ate, insulin taken, and blood sugars before and after meals, fasting and bedtime. Also corrections: what I took and my results. On a separate page I list what I ate.I use yellow highlighter for highs and blue highlighter for lows. For quite awhile I would look over each page as I completed it and see how many times I was too high, too low in each area, distinguishing between basal and bolus results. Then I would decide if it warrented changing basal or I:C ratios. Now my I:C ratios have been steady for long periods of time (months).

I’m a logical person so whenever I had a pattern of highs I wanted to know why. One smart person on here told me not to worry about why, just what to do about it. I still haven’t got a clear idea of how much LADA skews stability. Whenever I wonder if that is putting a monkey wrench in my stability many regular Type 1’s chime in that they have the same variability. I am coming to believe that some people just have more easily managed numbers, some people struggle all the time (what used to be called brittle) and most of us are in the middle. I’m happy if I’m in range 70% of the time. So some of it is lowered expectations. Perfection just isn’t in the offing. At least not for me. But yes, you can definitely expect more stability than you are seeing now.

My suggestions? Make one change at a time, because if you change too many things at once you don’t know what worked. When you make a change, hang with it for about 3 days even if it doesn’t seem to be working, so you can see the true results. Look for patterns. Same with your I:C, if you use 1:10 and are nearly always high after 2 hours, go to 1:9 for a few days. Expect to have different I:C rates for different times a day. Don’t worry about absolute numbers. If person A takes 10 units and you are at 30 and still high, than go to 32, especially when you aren’t sure of your type. If your regular highs start to become lows, back up the numbers a tad. Think about timing as well: Timing of your basal dose. If you’re taking one dose, think about splitting it. If you go to bed normal and wake up at 188 regularly you need more basal overnight. If you are high a lot after meals consider bolusing earlier. Don’t overtreat lows and be sure and correct highs using your ISF as well as you know it (be conservative if you’re not sure). Be sure and compute the IOB so you don’t stack insulin. If you’re high before a meal either correct first and wait for it to come down a bit or add the correction into the bolus. If you’re high drink a lot of water.

Mostly, hang in there. It won’t get perfect (until they find a cure) but it will get easier and less overwhelming. I was stressed all the time my first couple months. Good luck with the new endo.

Well I keep a great log and I always wait the days before changing doses. I just wonder of out gets any better after my pancreas stops producing.

GAD is the most common antibody detected in adult-onset Type 1 diabetes, followed fairly closely by ICA. Many adult-onset T1s are both GAD and ICA positive. IA-2 is common in children, rarer in adults, although a recent study I read said that 22% of the new-onset T1 adults in their LADA study were IA-2 positive. So you are pretty typical!

That’s interesting Melitta. I didn’t now about 1A-2 being rarer in adults. I tested positive fore both GAD and 1A-2. As much as I think I understand about this disease, I continue to learn more thanks to the community here. Thanks for that insight!

The evidence on antibody rates in diabetic patients is still what I would consider “sketchy.” It is really not known whether antibody levels rise and dissappear over time or not. Different people may have different manifestations of autoimmune disease or they may be different paths of progression or we may just be measuring people at different times during the progression. I don’t think anyone knows. The point is that being diabetic and testing positive for any “one” of the three antibodies confirms type 1, but it doesn’t confirm insulin deficiency and it doesn’t really help you know how you condition will progress.

there you go teaching again=)! I have read many articles that say you progress faster if you have gad-65 and IA-2, but I will agree there is so much unknown. I will indeed have to agree with the rest though. I do think that sometimes people have had it for awhile and then get discovered, but who knows how long they had to progress. This board has certainly gave me answers. Did you ever have your GAD-65 test done or are you still trying to get it done?

I had a GAD65 which came back negative. So all that means is that I was unable to confirm T1, there is still signicant uncertainty about my diagnosis.

I dropped the combination medication regime and started insulin in December, so it doesn’t matter. In the end, I could beat myself up with questions about what kind of diabetes I have and all that really matters is getting effective treatment. So now that I am on insulin I am happy to just let the matter sit. Perhaps at some later point I will have to revisit in order to qualify for a pump. But right now, I don’t want a pump and intensive insulin treatment is working and I am happy.

Yeah for the happy part! Really awesome, Brian.

I didn’t ask about the gad-65 for pumping reasons. I just never heard your results.