Positive Gad Antibody Results

[MartyP]

I am a 45 year old woman, 60 pounds overweight.  I am losing weight and currently take 2500mg of metformin per day.  My blood sugars are never over 200 and usually range from 90 to 150.  Recent bloodwork has shown that I am positive for GAD antibodies.  I have been told that <2 is normal and mine was +12.  I have been put on a very small dose of Lantus as well!  Am I becoming Type I?  I know that I am insulin resistant, and borderline Type II...my highest A1c within the last year was 6.2.  It usually stays at 5.8 or 5.9.
Will the Lantus stop what the antibodies have started...will my pancreas completely stop making insulin due to the antibodies?  Can anything stop it?  I know continued weight loss and exercise will help Type II, but what about Type I.  Am I doomed?  Thanks for any assistance!

[JDRF-Team-sgg]

I am not a doctor, and so my answer is based on what is available to the public as far as reading material on GAD antibody studies.

From what I have read about positive GAD antibodies and diabetes, the presence of positive results does not mean an automatic 100% chance of developing either type 1 or type 2 diabetes. Many studies are being done now on GAD antibody markers in order to better understand the correlation, but apparently not ALL people with positive levels develop diabetes. Positive levels seem to indicate that the chances are elevated that the person will develop latent onset type1 diabetes, but  not all people whose levels are elevated become diabetics.

What your doctor is doing is the typical treatment for the condition you describe. Studies to seem to indicate that starting the patient on Lantus may help protect the paitent whose autoimmune system is actively attacking the pancreas and may preserve pancreas function even if the pancreas is damaged.

So, no, I do not believe you are doomed to type 1 diabetes, no matter what you do. The weight loss is critical to your health, though, so keep up the good work in that regard and try to get down to your ideal weight in order to reduce the insulin resistance factor. We hear from many people who want a clear label of type 1 or type 2 diabetes, and for many people, the situation is really something in between the two. The label is really not as important as that a1c level. It sounds as if you and your doctor are doing all the right things to keep you healthy.

[Markie]

Testing positive for the GAD antibodies means that your immune system is attacking the insulin-prodcing beta cells in your pancreas. Sounds like you have identified this very early. But, unfortunately, there is nothing you can do to stop it from happening.

At best, the Lantus will rest your beta cells and prolong their remaining life. But the eventual outcome will remain the same - you will eventually become totally dependent on injected insulin.

It would be interesting to know how much insulin your pancreas is still producing. And an insulin level test will show this. If you are insulin resistant and your blood sugar levels are still quite low, you must be producing lots of insulin. And taking an insulin sensitizer like Actos or Avandia could help a lot.

In my humble opinion, the best thing you could do now is go on a low-carb diet. It would reduce your insulin requirements substantially, bring your blood sugars down, and rest your highly stressed beta cells.

Cheers,

Mark

[paralegal]

Hi, I am a diabetic and don't know too much about Gad antibodies except that it happened to me before they could test for it.  Lantus is great but, also, you might ask about anti-inflammatories - if that might help retard the destruction rate.  I remember reading something about the fact that if diagnosed early, there was hope that by using strategies and (possibly anti-inflammatories) waiting for new treatments, it could be completely prevented or slowed.  Judging from comment above, look for supplements and anti-inflammatories that are targeted at lowering inflammation levels.  Even if not effective against the specific auto-immune response to islet cells, it would serve to reduce the general effects of inflammation from other sources and ameliorate the problems eventually caused - heart disease and other complications.  

Hope that you can find some help soon.

[clark@kent]

MARTYP said: my highest A1c within the last year was 6.2. It usually stays at 5.8 or 5.9.
I am jealous!  If your A1c remains below 7.0, that is quite good. If it remains at or below 6.0, that is great! The american assoc. of endocrinologists (don't know if this is the exactly correct name) recommends HbA1c of 6.0 or below.

So, as long as your blood glucose is well-controlled, as is yours, you should not have to worry about complications. I believe if you ask an endocrinologist, he/she will say "it's the blood glucose which, if at a high level, does all the damage". So, keep it under control and you should not have to worry.

Your control methods: do they include regular exercise?

[clark@kent]

HELP! TRYING TO LOG OUT!

[Emily779]

The comment that says that Lantus will preserve your functioning beta cells is not true. It will replace some of the insulin your body is not making.

Sounds like you should keep a good eye on your blood sugars at this uncertain time.  Your doctor's advise seems strange.  You are on a type 2 and a type 1 treatment??!!

I hope things get clearer soon.

[kimberly15]

I have what's called Diabetes 1.5 aka LADA which means I have type 2 characteristics but testing positive for GAD. As yours, my body is attacking my pancreas and eventually it will kill off the beta-producing cells and I will be completely reliant on insulin. Because my body is producing some levels of insulin (still quite high at the moment) I am not a type 1, hence the type 1.5 label.  

My GAD results were at 50 but my doctor said he's had some patients with numbers in the 1,000's so I was doing quite well and, combined with still fairly high insulin production, hopefully I can delay the onset of full type 1 diabetes.  I am also taking small doses of insulin my Hb1ac is over 8 though hopefully my next test will be lower.  You seem to be doing really well - I would make sure you get your blood sugars tested regularly to keep on top of your progress.

[Zoelula]

Just a brief clarification: You don't change Types. The type, simply put, distinguishes between autoimmune types of diabetes (Type 1.5 and Type 1) where the prime characteristic is that antibodies destroy the beta cells and insulin deficiency is the problem that occurs rapidly (Type 1) or more slowly (LADA/1.5). Type 2 is characterized more by insulin resistance. The body produces sufficient or even an excess of insulin but is unable to use it well. Over time , however, insulin production decreases for Type 2's as well, but they don't then become Type 1's. About 15% of people originally diagnosed Type 2 (I'm one of them) were misdiagnosed and are in fact LADA/1.5. My Type didn't change, it was just incorrectly diagnosed to begin with. I'm not producing a lot of insulin right now (though I occasionally have little spurts of increased production), and in time I will cease to produce any and be completely insulin dependent just like a Type 1. However my type won't change because type has to do with how the diabetes developed and for LADAs this means slower onset than Type 1.