September 12, 2004
Diagnosis and Symptoms, Other
Question from New Carlisle, Indiana, USA:
Is it possible to have high GAD positive titre(0.67), decreased first phase insulin response (45), and never develop diabetes? My daughter had a negative IA2 and no other antibodies were checked. Would these tests resolve sometimes?
Three years ago, my 10 year old daughter was told she would get type 1 diabetes “very soon.” She has Addisons, vitiligo, very mild mental retardation, chronic neutropenia, hydrocephalus, ASD heart defect, spine defect, and liver enzymes (mild). Could the doctor have been wrong? Would any of these diagnosis have altered the tests to look positive? Are there any other new tests that have been developed that could put this worry in the back of my mind to rest? She has many problems that are challenging to her, I am hoping we can forget about the possibility of diabetes.
Answer:
We just don’t know the exact answer to your question. The higher the antibody titers and the lower the first phase insulin response, the more likely will be development of diabetes. If there are also other autoimmune disorders, this would tend to make the risks higher, not lower. The titers you describe are not very high, however, unless you are not quoting them correctly or the units are non-standard units. Another test that may be helpful is an islet cell antibody: positive and higher titers would be more worrisome than lower or negative titers. So, you should go back and discuss this with the doctors since they would have the most information for such questions.
SB
