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The Question
04/26/09 08:41 AM

"I was diaganosed with T2 16 months ago. Recently had a blood test for GAD 65, positive result >30. Now told that I will become T1? Is this true?"
Asked By:  
Category: Type 2

Background Info Hide
Onset of diabetes with A1C of 15, BS of 365 and in state of DKA. Was in hospital for 4 days. Now on Metformin, Januvia & Lantus Insulin. A1C went back to 6.7 and now rising again to 7.2 and back to 8.0. Morning fasting blood sugar was ok, but too much rise after meals. Doctor was saying, maybe you are really T1 and not T2? So I was then tested for GAD 65 antibodies and tested positive with a greater than 30 result. Now being told that these antibodies will destroy my beta cells? I ask for the C-Peptide test and the doctor said, I will run it , but don't ask me what it means! I just had a C-Peptide test done, but was not fasting. C-peptide was 0.3 and glucose was 65? What does this mean? I just added Rapid acting Humalog before breakfast. My muscles ache so I had a CK total test run with a positive 1495 result. Now my Dr. wants me to see a Rhuematologist? Can the muscles ache from too little insulin? Can the inflamation be caused by diabetes? So many questions and no one to answer.

Expert Answers (1)

01/28/10 11:26 AM

All of your questions are good ones. I hope I can answer in a way to make it easier for you to understand your test results. Type 1 diabetes is an autoimmune disease where the body self-destructs the part of the pancreas that produces insulin. Lab tests to diagnose type 1 diabetes include positive GAD antibodies, which indicate that beta cell destruction is occurring, and low or undetectable levels of C-peptide which reflect that there is little or no insulin being produced. LADA is a form of diabetes and it stands for latent autoimmune diabetes in adults. LADA is actually type 1 diabetes that does not occur until adulthood. The rate of beta cell destruction in LADA can occur rapidly or over several years. If it occurs over several years, some beta cells function remains for a while and the person with LADA may not require insulin. This is why persons with LADA may appear clinically to have type 2 diabetes. LADA may not become apparent until all the beta cells destruct over time and the person requires insulin injections. The presence of GAD autoantibodies and low or undetectable levels of C-peptide are present and help to confirm a diagnosis of LADA.

CK levels are elevated when there is muscle damage or inflamation. Different CK tests and help diagnose why the muscle damage or inflamation is present.

Muscle aches are not associated with taking too much insulin and are not commmonly related to diabetes. However, if you have one inflamatory disorder (like LADA), the chance that you have other inflamatory disorders is increased.

Your physician knows you best so you should defininely speak to him/her about your questions and concerns.

Your questions are good ones and don't be embarrassed to ask them. There are many medical care professionals who find the diagnosis of LADA confusing! Good luck!

Answered By: Donna Yuscavage
Accreditations: RN, BSN, CDE
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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