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July 20, 2003

Diagnosis and Symptoms

Question from Maryland, USA:

I am 41 years old, I have no family history of type 2 diabetes, I am not overweight, and I have a child with type 1 diabetes. I was recently diagnosed with hypothyroidism and noticed that my blood sugars were running high. My ICA are positive, the titer is 10 and my C-peptide level is 4. Do I have type 1 diabetes?

Answer:

Your C-peptide level (assuming it is in ng/ml) is normal, and you should check with the laboratory as to exactly what an islet cell antibody titer of 10 means. Different laboratories may use different techniques and different units so nowadays, they are supposed to say just ‘positive or negative’ based on being three standard deviations above or below a mean of a substantial number of normals.

Whatever the final interpretation though, if you have a child with type 1A (autoimmune) diabetes, a positive ICA screening test and high random blood sugars, then it is quite possible that you have a condition that is now known as Latent Autoimmune Diabetes in Adults (LADA). The underlying cause for LADA is quite different from that of type 2 diabetes, and it may occur as late as the sixth decade of life. However, without antibody testing, it may be difficult to disentangle the two types on purely clinical grounds. Your doctor has to decide whether to start insulin at this juncture, but it sounds as though she/he is well aware of this condition.

DOB