t2 & lada

Hi Everyone,

Diagnosed with T2 in 1978. Dieted, lost about 20 lbs, had normal normal weight and normal BGs until I was pregnant in 1988/89, which I expected. Was ok again until just under a year after my daughter was born. In those first few months when she was a baby, I had been diagnosed with Lupus (autoimmune).

For the D, I went from diet to tablets, which no matter which one I took, I had a bad reaction to, so I was put on insulin about 4 years ago, still with a normal c-peptide.

I hate the shots, so wanted a pump, but here, you can’t get consumables subsidised unless you’re a T1. I started asking for GAD testing, but my medical people said, ‘impossible’. A couple of weeks ago, my endo finally agreed. We also ran another c-peptide, which up to now had been within the normal range.

My GAD antibody test came back positive but negative on IA-2 antibodies. I had known about LADA for a long time and my test result truly surprised me because I do fit the profile for T2, always have! A little overweight, insulin resistance, high cholesterol (familial), familial T2 and so on.

I have zero undersanding of what the test results mean. I’m assuming this is done by titre? Do differernt result mean different things? Or if you’re positive, you’re positive, doesn’t matter about the number?

GAD Antibodies H 1011 u/ml (<10 is normal)
C-Peptide L 0.4 (0.5 - 1.0 is normal)

Is anyone familiar with this way of testing GAD Antibodies and whether the result is indicative of anything in particular? Is it usual with LADA to be at this level?

The other thing that interests me is that I must be having the longest honeymoon on record, if in fact I’ve had LADA since 1978. No one knows! The other option, of course is that I did have T2, and developed LADA around the same time I was diagnosed with Lupus. Could this make sense?

Anyway… would be grateful for any opinions, commentary, insight… and so on. At least now I can get a pump and subsidised consumables!

Cheers…
Sue

Hi Sue–Often the only antibody detected in people with LADA is GAD. If you are positive for any of the antibodies, including GAD, you have Type 1 diabetes/LADA. I don’t know anything about the GAD levels, so can’t comment on that. Many people with adult-onset Type 1/LADA still have some remnant insulin production for many years, so can have long honeymoons. Yours does seem extremely long! I am glad you are now able to get an insulin pump–I really think a pump is far superior to injections, in terms of quality of life and control. Good luck to you!

Melitta

Hi Melitta,

Thanks for your reply.

I guess no one can go back 30 years and say whether I had positive GAD then. It’s just as likely or unlikely. Anything’s possible. It will probably be one of those things that will annoy me forever, because there’s no way to go back and get a definite answer. Have to learn to live with that one.

But if I was positive for GAD 30 years ago, then it’s an awfully long honeymoon! Someone has reported 25 years, but that’s the most I’ve read about. Doesn’t mean it can’t be longer. I just haven’t read about it on the Internet and it’s certainly not the average or what’s usually reported.

Sue

Hi I think this is where I belong… LADA…not sure nor is the Endo. With all of your experience please help me determine any other tests or suggestions you have for me. I am on diet and exercise only after my third GDM pregnancy, I have a four month old. Here are my labs I am trying to understand…
GAD-65 AB is 1.7 (higher than normal) ??? Doc said positive.
Insulin Autoantibody <4 (in range)??
non-fasting c-peptide 2.2 ??means?
TNP- negative ??

Thanks for any help understanding, I don’t get back to Endo until June 8. Is this my honeymoon?
Islet cell antibody-negative
IGA- 4 (in range) ??what is this

I may have type II and type 1.5 on the way? Weird? Thanks for any help

Hi Dawn: If you are GAD positive, which is the interpretation of your doctor, you have Type 1 diabetes (or adult onset Type 1/LADA). GAD is the most common antibody seen in LADA. If it were my situation, I would want an earlier appointment with my endo to get on insulin. The earlier you get on insulin, the better the outcome in many different ways.

LOTS of women who have GDM go on to have full-blown Type 1/LADA. It’s not uncommon.

Melitta