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KCL

GAD65 positive (14.8) A1-2 negative A1c 11.8 waiting 2 months to see endocrinologist

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KCL

I am 65  and overweight and was borderline pre-diabetic for several years. Two months ago I suddenly I had symptoms of sudden weight loss, frequent urination, very blurry vision, exhaustion. One month ago, I had blood tests done and my glucose was 300, A1c was 11.8. Based on my glucose and A1C, the Dr diagnosed me with diabetes and put me on insulin and metformin. Dr did more tests found my GAD65 high positive at 14.3, A1-2 was negative with <7.5.  Dr thinks I might be Type 1 because of the GAD antibodies but wants me to see a Seattle endocrinologist. I have to wait 3 months to get an appointment and in the meantime I am still taking insulin and metformin. Opthomologist did diabetic eye exam and said no damage but blurry eyes may take a month or so to return to normal. I am keeping my blood sugar in range with meds and diet and exercise. I am worried and confused about my diagnosis of positive for GAD and negative for A1-2 and this all happening so suddenly. Any suggestions or information would be appreciated.

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meyery2k

@KCL - Welcome!  For now, until you have more information, I am not sure what else you can do.  Keep your blood sugar in check as best as you can.  I had blurry vision as my glucose came down.  It is alarming but, in time, my vision improved until it was better than ever.  Hopefully, some members with more knowledge will offer some advice. ~ Mike

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Kit

Hi @KCL welcome to the group and a big wave from another in the Seattle area.

 

I'm not sure how much you understand on the subject, so I am going to cover a lot of the basics.  Forgive me if you already know some of this information.

 

First off, T1 and T2 diabetes are completely separate diseases that happen to share a common symptom (high blood glucose levels).  So a T1 diabetic can be insulin resistant (I know we had a member here at one time where this was the case).  Theoretically a T2 diabetic could have an autoimmune attack and also become a T1 diabetic, though I have no first had knowledge of that situation happening.

 

So yes, you can be over weight and show signs of insulin resistance, and then have an autoimmune attack happen  and become a T1 diabetic with insulin resistance.

 

Second, as I mentioned above, T1 diabetes is defined by an autoimmune attack on the beta cells of your pancreas.  Since the beta cells produce insulin, this eventually kills off the body's ability to produce insulin.  There are actually a number of different antibodies that can be involved in this attack.

 

GAD65 or GADA - This is the most common antibody to be found in older patients

ICA

IA-2A

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Not all of the antibodies may be present, especially in older patients.

 

Third, you showed absolutely classic signs of the onset of T1 diabetes, specifically rapid weight loss.

See insulin is basically an energy storage hormone.  Someone who is insulin resistant will normally have high levels of circulating insulin.  This often causes weight gain.  Without insulin however, the body will literally waste away and you get rapid weight loss.

 

If your new endo does not give you an official diagnoses of T1 or T1,5 diabetes, I will literally fall over from shock.

 

I know the waiting can be frustrating, but, as Mike said above, you are already on an appropriate treatment course, insulin.  Whether or not you are insulin resistant, Metformin will not hurt you, so i see no need to worry there.  And that is good news about your eyes.

 

While you are waiting for your endo appointment, there are a few books you might find helpful.  I'm a big proponent of education.  You know, knowledge is power and all.  :)

 

Using Insulin by John Walsh

Think Like a Pancreas by Gary Scheiner

 

These two books will give you a better understanding of how insulin works and how to use it well.

 

There is also

The Diabetes Solution by Dr Richard Bernstein (an Endo and long time T1 diabetic).I wish you the best of luck.

Edited by Kit

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KCL

Thank you so much Mike and Kit. I will read the books you recommend and hopefully my health will improve. I am looking for a Diabetes specialist or endocrinologist in the Seattle-Tacoma area if anyone has a recommendation. U of W Diabetes Clinic can't give me an appt until the end fo March so in less I find out about another dr. I will go there. Thanks. 

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Kit

Sadly I can't help you there.  I'm a T2 on metformin alone, so I just make use of my GP.  Not that my GPs are particularly helpful, but good enough I guess for what I need.

 

Someone that might be worth looking at, not all endos specialize in diabetes, but other diseases as well.  You might want to make sure the one you find does indeed specialize in diabetes.

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Montana

As Kit mentioned this is type 1 diabetes or, more specifically in your case, LADA which is very similar to type 1 but is diagnosed in adults.  Some people refer to this as type 1.5 diabetes although that name has become a bit less favorable now since it is used for any diabetes that is "atypical".  You have antibodies since it is a form of auto-immune diabetes but not all antibodies need to be positive.

 

Most people with LADA will need insulin in the long term to stay healthy and out of the hospital.  It is probably best to see a specialist for it but hopefully your primary care provider can continue to help with your insulin doses in the meantime since it sounds like it is a wait to see a specialist.  Unfortunately, a two month wait time is relatively common in many parts of the US and actually some places have much longer wait times.

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