July 24, 2009
Diagnosis and Symptoms, Research: Other Research
Question from Grand Rapids, Michigan, USA:
When my son was diagnosed with type 1 at seven months of age (five months ago), he was in DKA with a blood glucose over 500 mg/dl [27.8 mmol/L]. He was tested for GAD-65 and ICA 512 at diagnosis; both came back negative. Subsequently, he was tested for neonatal diabetes (for the gene mutation), but everything came back normal. I’ve read that 15 to 20% of people with type 1 don’t have antibodies and it looks like our son falls in that category. Since he was tested at diagnosis, his antibodies still should have been present, so it’s not like they disappeared. Why is it that some type 1s do not have antibodies at diagnosis? I cannot find the answer.
Answer:
The test is a wee bit insensitive. Presumably, if one were to look at the pancreas itself under a microscope, this would still be autoimmune. But, this is not so practical. It is only helpful to know about antibodies for risk assessment of other family members or for research classification. Gene testing in very young ones, however, is extremely helpful if potassium channel markers are positive since this suggests pills instead of insulin would work.
SB
