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October 8, 2002

Diagnosis and Symptoms

Question from Cali, Colombia:

My 13-year-old brother was told that he has diabetes, and the doctors ordered a GAD antibody test, but this test is not available where we live. It is very important for him to take this test, so we will know if he has diabetes or if is just temporary diabetes. Where can the GAD antibody test be done in Colombia? If it is not available in Colombia, where in the United States? We can fly to the States with him anytime to take the test, and it will be It will be better if it is in Florida.

Answer:

It is not critical that the anti-GAD antibody test be done. Children were diagnosed with type 1 diabetes long before this test was discovered. Nevertheless, it can provide some prognosis and reassurance for families and physicians who are uncertain. The test may not be available in Colombia, but the blood should be able to be obtained and sent by air-carrier (e.g. Federal Express) to a lab that does the test.

I know that the commercial reference laboratory, called Esoterix (toll free number in U.S. is 800-444-9111) does it. The University of Florida in Gainesville used to do this test — I think they still do.

DS
Additional comments from Dr. John Schulga:

Diagnosing diabetes does not require the GAD antibody detection. The diagnosis depends on finding a high blood glucose concentration. However, it might help in differentiating between type 1 and type 2 diabetes if there is a concern that it might not be possible to know clinically. If your brother has lost weight and had urine ketones at diagnosis, it is more likely to be type 1 diabetes which will require insulin from the start.

JS
Additional comments from Barb Schreiner, diabetes nurse specialist:

You might try Dr. Jay Skyler’s clinic at the University of Miami. It may be possible to ship a frozen sample to his lab.

BS
Additional comments from Dr. Stuart Brink:

The test is one of experimental tests that look at diabetes type 1 antibodies. Islet cell antibody is one, insulin antibody is a second and the third is against an antibody called glutamic acid decarboxylase or GAD 65. There is no clinical reason to get this test and so no reason to spend a lot of money flying around the world or to the USA from Cali to get this test. Diabetes is a clinical diagnosis made by observing blood glucose levels. Antibody tests are very interesting to look at if part of a research protocol but do not add much information at all to how or when to treat children with diabetes under most circumstances. So be relieved that this is not necessary.

SB