Jeter02
06-17-2007, 05:56 PM
Here's my story:
Noticed frequent urination/thirst and went in for a random blood test. Sugars= ~300; A1C= ~8.5. Mid-twenties, non-obese (BMI of 24 or so). I was put on a very low-carb diet which I maintained for a week given the assumption I was a Type 2 diabetic. My blood sugar levels dropped considerably, and I have since been told to phase back carbs into my diet. Doing so has not yielded any chance in my blood sugar levels (fasting= ~95-100; Range= 85-105 during the day).
Was tested for antibodies as the docs suspected T1, but was negative across the board. Did have a lower-than-usual C-peptide, though. No one really seems to know if I'm T1 or T2, and I'm extremely confused (though not at all upset) as to why my blood sugars are doing so well when I'm on no insulin, medication, etc. I understand antibodies aren't ALWAYS present in T1...can someone elaborate on this a bit?
Ellen
06-18-2007, 10:55 AM
Have you read about LADA (latent autoimmune diabetes in adults)? I suggest you contact the researchers in Seattle who likely lead the research on LADA in the US. Dr. Jerry Palmer's email address is :
jpp@u.washington.edu . He's written extensively on immunology of diabetes and is one of the authors of the following. My friend flew to Seattle years ago to participate in some LADA research and was most impressed with their work there.
Here is one recent abstract from the upcoming ADA 67th Scientific Sessions:
T Cell-positive Antibody-negative Phenotypic Type 2 Patients, A Unique Subgroup Of Autoimmne Diabetes.
Year: 2007
Abstract Number: 1258-P
Authors:
HEBA M. ISMAIL, MICHAEL WOTRING, CRYSTAL KIMMIE, LIEMIN AU, JERRY P. PALMER, BARBARA BROOKS-WORRELL, Seattle, WA
Results:
Type 1.5 diabetes or LADA comprises approximately 10% of Caucasian adult phenotypic type 2 diabetes patients. Whereas, the presence of autoantibodies (Ab) and T cells (T) reactive to islet proteins suggest an autoimmune pathogenesis, classic type 2 patients are negative for both. LADA patients are usually defined as Ab+, but it has also been observed that most Ab+ patients simultaneously demonstrate T cell responses to islet proteins. We, however, have recently identified a group of phenotypic T2DM patients who are T cell positive but autoantibody negative.
Our aim was to determine whether T cell-positive (T+) autoantibody-negative (Ab-) phenotypic type 2 diabetic patients become Ab+ with time or whether they remain antibody negative and constitute a separate subset of autoimmune diabetes.
This data was taken from a prospective study where phenotypic type 2 patients have been evaluated every 3 months for up to 36 months. Patients were classified as phenotypic type 2 by their physicians. We assessed each patient's T cell responses to islet proteins (using cellular immunoblotting) and autoantibody responses (IAA/IA-2/GAD) during each follow-up visit.
At baseline we identified 13 patients that were T+Ab- and an additional 12 patients were identified during follow-up. Of the T+Ab- patients, 17/25 (68%) did not seroconvert and remained Ab- during a median follow-up duration of 21 months (range 3-36). Only 8/25 (32%) developed Ab reactivity during a median follow-up period of 30 months (range 12-36). Of the T+Ab- patients who seroconverted, only one out of the eight patients remained persistently positive for both GAD and IA-2 antibodies during follow-up. The remaining 7 patients (87.5%) demonstrated transient autoantibody positivity. Of these 7 patients, one was positive for IA-2 at one time point, 4 were positive for either GAD (3 patients) or IA-2 (1 patient) at two time points, and 2 were positive for both GAD and IA-2 at one or two time points respectively. This Ab positivity, however, was not corrected for by multiple testing.
Although some T+Ab- patients seroconverted to autoantibody positivity during follow-up, the majority (68%) remained autoantibody negative. Most T+Ab- diabetic patients belong to a unique subgroup of autoimmune-mediated diabetes that would not be detected using autoantibodies alone.
Category:
Immunology
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Here's an article:
http://diabetes.diabetesjournals.org/cgi/content/full/54/suppl_2/S62
Is Latent Autoimmune Diabetes in Adults Distinct From Type 1 Diabetes or Just Type 1 Diabetes at an Older Age?
Good luck in your research.