Welp we got all but 1 test back. They are as follows... HBA1c 6.9
urine 500mg +2 glucose
C-peptide fasting 1.18 lab said normal is 0.8-3.1 so it is normal
Inslet Auto something normal
Waiting on IA-2
So looks like all we have again is my son is GAD+ back to sqare one of not knowing what is going on. I want to be happy that it looks normal but fact is something is wrong and not getting answers... just say he is complecated to figure out. His body is just not easy to figure out. If IA-2 is normal all crack. No answers to anything. Sugar test all 130 to 270 had a few at 300 . Doctor said wait and see what the IA-2 test says. Isnt that a test they do only on type 2
GAD 65 is considered to be the most prevalant and reliable auto abtibody marker in T1 diabetics. Many of us including myself are only GAD65 positive. If your child has bg at 270+ and is GAD65 positive, he has type 1 diabetes and there isn’t much more story to tell by any other antibody test. The good news is that you have figured it out quite early, before damage has been done. Now the name of he game has to be learning how to manage it and control his blood glucose levels by whatever means necessary…
Long story short. We got a referal approved but doctor who insurance has us going to is booked till January but said for my GP to run these test and fax him the results and depending on those he will stick with appointment in January or move it to sooner.
Can you tell me what the IA-2 test will tell us...
Well at least he’s got someone looking into it. Realistically, I don’t think the IA-2 test has much of any value at this point in helping to determine anything. Especially since he’s already been found to be GAD 65 positive, whether IA2 is also positive or not really doesn’t change anything in my estimation… If GAD was negative but one or both of the others were positive that might be meaningful, but otherwise I doubt it means much one way or the other. Although I’m not an expert just a patient myself. I hope the specialist sees your son soon and helps you get this all figured out. It’s not easy, everyone here knows that, but it is manageable.
Years ago, there really wasn't anyway to see the onset of diabetes like we can today. Today, we recognize T1/LADA as a very specific type of autoimmune attack. It is characterized by one of three antibodies GAD, IA2 and ICA. Sometimes, even normal people can have a flareup of an autoimmune attack and these antibodies can be present, but they don't go out of control. When they do go out of control, they attack the pancreas and your insulin production and once so much has been destroyed that your blood sugar starts to become abnormal, then you are thought of as a T1/LADA. Since normal people carry around like 10 times the insulin capacity that they need, these blood sugar abnormalities are not always obvious.
So, your son is GAD positive and with an A1c of 6.9 and blood sugars all the way up to 300 mg/dl, he has all the markers that support a diagnosis of T1/LADA. T2 doesn't really exist as a diagnosis, it is a diagnosis of exclusion (I believe it should just be called diabetes).
And to support what Sam said, the IA2 would provide almost no added information, it could only further confirm T1/LADA, it has no relationship to diagnosing T2. There is an increasing belief that diagnosing T1/LADA early and initiating proper treatment (insulin) and maintaining good blood sugar control leads to the best outcomes. If your doctor just wants to wait around until your son has a trip to the emergency room, then he is not doing his job and you need to find someone competent.
The reason for the IA-2 test: If it is positive then it's almost 100% guarantee of Type 1 diabetes . Many Type 2's can show positive results to GAD65 but IA-2...is zero in a T2.
Mayo says: GAD 65
Assessing susceptibility to autoimmune (type 1, insulin-dependent) diabetes mellitus and related endocrine disorders (eg, thyroiditis and pernicious anemia). Titers generally < or = 0.02 nmol/L. A second islet cell antibody, IA-2, is more predictive for development of type 1 diabetes, but less frequent than GAD65 Ab amongst diabetic patients. Insulin autoantibodies also serve as a marker of susceptibility to type 1 diabetes.
Distinguishing between patients with type 1 and type 2 diabetes. Assays for IA-2, insulin, gastric parietal cell, thyroglobulin, and thyroid peroxidase antibodies, complement GAD65 antibody in this context. Titers generally < or = 0.02 nmol/L.
There are also many other ugly conditions that cause a positive GAD65 tests along with high BG....this test is not exclusively used for just detecting diabetes. Trust me when I say diabetes could be a lessor evil than some of the other conditions, be patent.
All this lost me LoL. He is 13 and yes already had a trip to the ER he was at 320 so I went and they did A1c it was 6.8 and a urine had glucose. After 7 hrs his sure went down to 121 so they sent us home.
Ok,I'm assuming you are either trying to confirm Diabetes diagnosis, and/or determine Type. An A1C of 6.9, I'm sorry to say, is not normal. 6.5 and above are considered Diabetic, and your meter readings indicate that clearly. As for the C-peptide, it doesn't come in "normal" or "not normal". It is one of the tests used to determine type. Type 1 is generally below range. Type 2 is either in range or high. So your c-peptide is a bit uncertain. However if he is GAD positive, then he is Type 1. The antibodies are the final determinant.
Yes but seems for 2 years now all the doctors are giving me the run around. They do all these test and just say we need to wait. So frustrating. Now here we are 2 years after he has had signs and GAD and I still have no answers. The GP is doing his best since my insurance referral took forever and now the appointment is 3 months away. The reason i gather they said his c-peptid was normal was because it was within range. They did a insulin auto antibody he said that was negative or normal so now we wait on the IA-2. I give am not sure what the heck to think. I am trying to make sure I can at least help with his diet. This morning was 149 so that is the 3rd one this week over 120. All yesterday was over 160. His night time was 197. Maybe stuff is different in Utah because I dont feel like doctors are worried YET I am. Maybe it is because am mom :(
I hate to be blunt, but if it were my child I'd take him to another doctor. He is Type 1 and needs to be on insulin. Any doctor that would allow him to remain consistently high is performing malpractice imho.
I HAVE I am on doctor #3 and I have taken him to the GI too says all looks fine. I am on my 3rd Gp also and this will be the 3rd Endo. He has been to the ER a few times. Had every test they can think of. I have spent savings going to other doctors which found nothing except he might be type 1 lets just monitor him. Another doctor wanted him as a test study. They had his as a candidate to develop type1 2 years ago and said we will monitor him. Another Doctor said yes he is GAD positive that don't mean he will get it would you like to join my study. Son is not a guinea pig sorry. I want answers and honestly I feel like I have gone out of my way to get them but tests are not revealing anything to the doctors. Not sure they kow what to do. Just say it is complicated. My insurance isnt helping the situation.
Something isn't making sense to me about this.What do they mean by "everything looks fine"? Has he been diagnosed with Diabetes, just not confirmed as Type 1?
If they are treating him and assuming him to be type 2, his numbers should obviously show the treatment is not working? Why would any doctor allow him to remain high? Are they at least trying different oral meds? If they are hung up on the differential I would still insist on insulin to get his numbers in range. Insulin is used on type 2 as well as type 1.
I was just about to post this suggestion as well. Medical professionals answer the questions, so they might be able to provide some insight or some resources that will help.
I agree, Zoe. Something doesn't seem right with this. Clearly, this child (don't know his age) has a high A1C and blood sugars. Was the cpeptide done fasting with BG's below 200, it has to be a fasting test. IDK, this all seems very odd.
