Diabetes Test Results

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paulgrolle

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Hello there.
I have these diabetes test results from a few years ago. I paid private because the nhs didnt run a gad antibody test at the time.
Can someone please tell me if these results indicate type 1, lada, type 2, or another type? I am officially diagnosed type 1, on Insulin.
But my new nhs specialist seems to think i am type 2, why? i do not know. but ive had this before, time and again.
I was initially diagnosed type 2 for a year and i was skin and bone before i paid for a gad test at nuffield.

gad result.jpeg

Can any experts here make sense of the results? Please feel free to message me. i appreciate you help.
Thanks for your time.
 

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Welcome to the forum @paulgrolle

You aren’t alone in having a diabetes that seems almost deliberately slippery and elusive

@Lucyr has been wrestling with an undefinable diabetes for years!

GAD antibody and cPeptide results are notoriously difficult to interpret. You can have ‘classic’ T1, and have no recordable antibodies (because all your beta cells have been destroyed, and the antibodies have now disappeared). Or you can have had ‘classic’ T1 for years (decades!) and still have detectable cPeptide - as medallists at the Joslin Institute in the US have demonstrated.

My guess is that the right-hand column looks to be a sort of reference range (based on the glucose values). And if I’m right, it looks like you have quite a high level for antibodies, and a low level for cPeptide (your natural insulin production).

A diagnosis of T1 in your 40s is far from rare. We have many members here who were diagnoses as adults. 30s, 40s, 50s, 60s and older!

Sounds like you lost a lot of weight before diagnosis? (Thirsty, Tired, Toilet, and Thinner are the 4Ts of T1)

Are you treated with insulin? Basal (background) and bolus (rapid-acting mealtime). And is this going to continue?

I’m just trying to understand how you will benefit from a reclassification? There certainly seem to be some T1 markers to my (unqualified) eye.
 
did the private clinic not give any advice on what to do before the tests?

Your antibodies are high but not crazy high, which means more likely t1

Your cpeptide is within the normal range, but your glucose at the time was only 4.6 which means this basically doesn’t tell you anything much. Your body is producing some insulin, but it doesn’t really tell you whether it’s a low/normal/high amount because your body wouldn’t have much need to produce insulin with a bg of 4.6

The advise from my consultant was to do a stimulated cpeptide test. This means eating a meal 90mins - 2hrs before the test, without taking fast acting insulin for it. Your body is then stimulated to produce as much insulin as it can to get the bg down. If it’s high then that shows body is capable of producing plenty insulin so likely t2, if it’s low then points to more likely t1.

If your NHS medical record says t1 then honestly I wouldn’t push for more tests unless you feel it’s both realistic and appealing to try stopping insulin. I wouldn’t risk losing a T1 diagnosis personally, so if you can do any “I’m happy to keep the t1 diagnosis given history and antibodies” to keep it then I’d do that. T2 qualifies you for naff all really.

If you search for my thread, somewhere I’ve recorded my results. The scales won’t be the same but might help.
 
Lucyr said:
did the private clinic not give any advice on what to do before the tests?

Your antibodies are high but not crazy high, which means more likely t1

Your cpeptide is within the normal range, but your glucose at the time was only 4.6 which means this basically doesn’t tell you anything much. Your body is producing some insulin, but it doesn’t really tell you whether it’s a low/normal/high amount because your body wouldn’t have much need to produce insulin with a bg of 4.6

The advise from my consultant was to do a stimulated cpeptide test. This means eating a meal 90mins - 2hrs before the test, without taking fast acting insulin for it. Your body is then stimulated to produce as much insulin as it can to get the bg down. If it’s high then that shows body is capable of producing plenty insulin so likely t2, if it’s low then points to more likely t1.

If your NHS medical record says t1 then honestly I wouldn’t push for more tests unless you feel it’s both realistic and appealing to try stopping insulin. I wouldn’t risk losing a T1 diagnosis personally, so if you can do any “I’m happy to keep the t1 diagnosis given history and antibodies” to keep it then I’d do that. T2 qualifies you for naff all really.

If you search for my thread, somewhere I’ve recorded my results. The scales won’t be the same but might help.
Click to expand...
Thanks for your reply. I really dont want to pursue a new range of tests, which i why i asked for these old blood test results from nuffield. My new nhs specialist says that if i am type 2, i will be put on a round of type 2 drugs but i said I dont really want my insulin taken away and put on some type 2 drugs that wont work. But he seems to really want to pursue this line of enquiry which scares me. Its just a hunch on his part but seriously dissruptive to me. When i was initially diagnosed type 2, the metformin and what ever else i was talking didnt do anything. it was only insulin that worked. If anyone else can reply and say that its probably type 1 please post a message. the more replys the better . thanks
 
everydayupsanddowns said:
Welcome to the forum @paulgrolle

You aren’t alone in having a diabetes that seems almost deliberately slippery and elusive

@Lucyr has been wrestling with an undefinable diabetes for years!

GAD antibody and cPeptide results are notoriously difficult to interpret. You can have ‘classic’ T1, and have no recordable antibodies (because all your beta cells have been destroyed, and the antibodies have now disappeared). Or you can have had ‘classic’ T1 for years (decades!) and still have detectable cPeptide - as medallists at the Joslin Institute in the US have demonstrated.

My guess is that the right-hand column looks to be a sort of reference range (based on the glucose values). And if I’m right, it looks like you have quite a high level for antibodies, and a low level for cPeptide (your natural insulin production).

A diagnosis of T1 in your 40s is far from rare. We have many members here who were diagnoses as adults. 30s, 40s, 50s, 60s and older!

Sounds like you lost a lot of weight before diagnosis? (Thirsty, Tired, Toilet, and Thinner are the 4Ts of T1)

Are you treated with insulin? Basal (background) and bolus (rapid-acting mealtime). And is this going to continue?

I’m just trying to understand how you will benefit from a reclassification? There certainly seem to be some T1 markers to my (unqualified) eye.
Click to expand...
Thanks for your reply. I am on Insulin both basal and fast acting. Yes I was thin at diagnosis, lost weight in a short space of time. continued to lose weight. the nhs ran a beta cell test at first which came back inconclusive or not showing any problem.They never did a gad65 test as it was not available on the nhs. i was then diagnosed type 2 and put on boxes of metformin that never worked. after 12 months i went private for the gad test. the results are in my previous post and my old nhs specialist diagnosed me as type 1. gad positive.
But this seems to now be a problem... because i went private, my new nhs specialist seems to be suspicious of the diagnosis and wants a new round of bood tests. which i declined.
You see, i am not positive that its type 1 or type 2 but I dont want to change to type 2 yet again, be placed on type 2 drugs that dont work and lose my insulin.
Thats the main issue here. I dont like to be treated like some experiment. As far as i am concerned i am diagnosed.
 
Is your diabetes management regime working?
If the basal bolus insulin is maintaining an "acceptable" HBA1c, etc. why would any doctor want to change that regardless of any test results. Surely, the best test for the medication is that it works.
If it is not working, it is worth further investigation.
 
paulgrolle said:
Thanks for your reply. I am on Insulin both basal and fast acting. Yes I was thin at diagnosis, lost weight in a short space of time. continued to lose weight. the nhs ran a beta cell test at first which came back inconclusive or not showing any problem.They never did a gad65 test as it was not available on the nhs. i was then diagnosed type 2 and put on boxes of metformin that never worked. after 12 months i went private for the gad test. the results are in my previous post and my old nhs specialist diagnosed me as type 1. gad positive.
But this seems to now be a problem... because i went private, my new nhs specialist seems to be suspicious of the diagnosis and wants a new round of bood tests. which i declined.
You see, i am not positive that its type 1 or type 2 but I dont want to change to type 2 yet again, be placed on type 2 drugs that dont work and lose my insulin.
Thats the main issue here. I dont like to be treated like some experiment. As far as i am concerned i am diagnosed.
Click to expand...

How many years ago did you have the tests @paulgrolle ? I had Type 1 antibodies tests, including GAD, around 5 years ago on the NHS. If the insulin is working for you, could you simply say that - what you’ve said here?
 
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