I'm a 42 year old male. I've been seeing an Endocrinologist for the past year and a half due to a subclinical hypothyroid issue. My TSH has flucuated from 6.5 - 7.8 with hormone levels in the low normal range. I also tested positive for thyroid antibodies. The approach has been to monitor this every 6 months. On my last visit we decided to try a low dose of Synthroid (25mcg) because of fatigue and depression cycles.
I'm a runner and typically run about 25-30 miles a week. I'm trying to get in shape for a marathon in a few months.
My primary doctor had done a few fasting glucose tests over the past year which were a little high. One time it was 110, another time it was 104. My last A1C was 5.8.
Because of the "impaired fasting glucose" my Endo ordered a Islet cell AB and GAD-65 AB test. The Islet cell AB screen was negative but the GAD-65 AB came back positive at 18.2.
My Endo has had me checking my glucose levels before meals and at bedtime for the past week. Those have all looked pretty good (I guess). Most in the 90's, a few in the high 80's. A couple slightly over 100 but possibly because of a snack eaten a short time before the check. She only wanted me to cal her if my levels were consistently over 110 before meals and at bed.
At this point my Endo told me not to get too excited but she thinks I might have early stages of type I Diabetes. I see my primary doctor in a few days for a normal HDL level followup (I take Niaspan to help boost my HDL - last HDL was 51), are there any other tests we might want to do at this point because of the GAD-65 positive? Do I need to check my glucose levels after meals?
All of the info I've seen on the GAD-65 AB test shows it as an indicator of future type I.
GAD antibodies are an indicator of autoimmunity related to Type 1 diabetes, and having it positive does put you at higher risk for developing diabetes in future. Given that you also have positive thyroid antibodies, you are in general more likely to develop other autoimmune conditions in future as well.
Your blood sugar levels right now are mostly within the normal range aside from some mild elevations in your fasting levels. A C-peptide level will give some indication of how much of your own insulin function remains, so this is useful to know.
Checking blood sugars after meals may also offer some information in terms of how well your body is able to handle glucose loads right now and if medications is needed yet. Hope this answers your question. Take care.
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