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No auto antibodies

Discussion in 'Parents of Children with Type 1' started by mysweetwill, Feb 20, 2012.

  1. mysweetwill

    mysweetwill Approved members

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    I am perplexed probably more than I need be. We just got all our son's labs back and W has no autoantibodies except for slight showing of insulin autoantibody which I understand can be present in anyone on an insulin regime. A search here showed he isn't the only Type 1 without autoantibodies, but the more I read the more questions I have. Two endo's I've spoken to don't seem to have many answers either. Neither think a gene mutation could be the cause of his diabetes and neither can fully explain why some type 1 kids don't have autoantibodies. Doesn't it defy logic? Does anyone have any further insight?
     
  2. ecs1516

    ecs1516 Approved members

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    I think the type auto antibodies only last for a period of time while destroying the inset cells. I think.
     
  3. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

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    Part of it is just how many antibodies they test for. If they only test for the ones I was tested for at dx (GAD 65, IA2, ICA 512), about 1 in 5 type 1s will be antibody negative (I was antibody positve for GAD 65 and ICA 512 myself). If they threw in all three of the ZnT8 antibody tests, the percentage of type 1s who'd still be antibody negative, depending on the age group, could be as few as 1 in 20.
    So if they only tested for the standard panel that they do, it's possible they just missed whatever antibodies your son actually has.

    There are some people who are antibody positive at or before diagnosis who become antibody negative.

    Some kind of insulin antibodies show up in people on insulin but I am under the impressiont that other insulin antibodies can cause diabetes. What's your doctor say about the specific insulin antibody W was positive for?

    There are also non-autoimmune forms of type 1 diabetes (type 1 diabetes just means that the person's diabetes is primarily caused by an inability to make insulin rather than insulin resistance). Non-autoimmune diabetes, or type 1b, can be caused by a lot of different things, some of which are known genetic conditions, genetic and non-genetic syndromes and conditions, and things that are unknown.

    If W is antibody negative, and a c-peptide showed lack of insulin production, then I don't think further testing is warranted unless he shows other signs of syndromic diabetes.
    If W is antibody negative and has not had a c-peptide test, one is warranted to show that W has type 1 diabetes.
    If W is antibody negative and had a c-peptide test that showed significant insulin production (whether low, normal, or high) it might be worth it to test for or consider the possibility of a diabetes that can be treated without insulin. If W had had a high c-peptide, he probably would not be diagnosed with type 1 diabetes, but type 1 diabetes is often diagnosed in people with below normal but positive c-peptides, or even low normal if the thought is that the type 1 diabetes has been caught early. If antibodies are positive, that then suggests that the diabetes is in a honeymoon stage and will get worse.
     
    Last edited: Feb 20, 2012
  4. mysweetwill

    mysweetwill Approved members

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