DIABETES - JUVENILE TYPE I COMMUNITY
Interpreting Lab Results

Interpreting Lab Results

My 12 year old daughter was diagnosed with type 1 diabetes in September...she has been insulin free since October 28th and doing fine so far.  We just saw the doctor yesterday to get lab results for further testing (thyroid, cortisol, etc.)...He did not fully explain some of the results I'm seeing here and was wondering if anyone could help me out with what they may mean???

Her C-Peptide level was 3.2 ng/ml (not fasting)
Insulin Level 17.3 mcu/ml\
GAD Antibodies 250 iu/ml
Glycolated hgb a1c of 13.1

He basically said that she definitely has type 1 based on her GAD test...but I'm reading that some people with insulin resistant type 2 have positive antibodies as well.  I'm not a rocket scientist, so if someone could please explain to me in layman's terms, I would greatly appreciate it.  My daughter has had several health problems in the past (since birth) ranging from seizures, mitochondrial disease, to Kawasaki Disease and Atrial Septal Defect.  I'm just trying to figure out if something else may be causing these problems (maybe the Mito disease???)

Any help would be greatly appreciated...thank you.

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Hi

I can't speak to your daughter's other problems, but I'm confused about her diabetes treatment. You say the doctor said she is "definitely Type 1" and yet he doesn't have her on insulin?? You said she is doing well but her A1C of 13.1 is extremely high and doesn't indicate at all that she is doing well with her blood sugars. Do you test her blood sugars on a regular basis? What sort of numbers are you seeing fasting and two hours after meals? It sounds like she is still making a fair amount of her own insulin so she may be in the "honeymoon phase" but the belief is that insulin use will help slow down the attack on the beta cells to extend that honeymoon. Is she seeing an endocinologist? If not, I suggest she do so. I also suggest you see an endo who is going to explain to you what is going on with your daughter's diabetes to your satisfaction.

To my knowledge, no, Type 2's do not have positive antibodies. It is an entirely different type of diabetes based on insulin resistance not an attack on the beta cells.
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Insulin is a small protein consisting of
    * an alpha chain of 21 amino acids linked by two disulfide (S—S) bridges to a
    * beta chain of 30 amino acids.
Beta cells have channels in their plasma membrane that serve as glucose detectors. Beta cells secrete insulin in response to a rising level of circulating glucose ("blood sugar").  When beta cells are attacked their insulin release is restricted.
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I'm sorry, I misspoke...her A1C was 12.7 when first diagnosed.  I meant to say 7 now....sorry bout that.  She is seeing an endocrinologist, but she's not on insulin because she was going too low and they had to wean her off...for now....thank you for all the information.  We just met with the endo on Friday, but couldn't ask all the questions we had because of time constraints.

Thank you.
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Ah, much better!! Best of luck to you.
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