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CONFIRMATION

POSITIVE

for 1 Ab

Serum Confirmation*

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*  Reference lab: CLIA-approved laboratory,
   ideally IASP participant, which is able to
   measure all 4 Ab:
 GAD65A, IA-2A, Insulin,
   ZnT8A.

Obtain Random Blood Glucose (RBG) and HbA1c

Follow-up to monitor for medical safety and progression to T1D

Normal RBG <140 mg/dL

and HbA1c ≤ 5.6%

RBG 140-199 mg/dL

OR HbA1c 5.7-6.4%

RBG ≥ 200 mg/dL

OR HbA1c ≥ 6.5

• Educate for symptoms of
   hyperglycemia

• Repeat Ab at reference lab*
   in 1 year

Higher Intensity follow-up

Assess/Educate for
   symptoms of hyperglycemia

Instruct on HGT 3**

 

• Referral to pediatric/adult
   diabetologist

•  Evaluate for symptoms of  
   
hyperglycemia and ketosis***

 

•  Verbal consult with and urgent
   referral to pediatric/adult
   diabetologist

*  Reference lab: CLIA-approved laboratory, ideally IASP participant, which is able to measure
   all 4 Ab: GAD65A, IA-2A, Insulin, ZnT8A.

**HGT (Home Glucose Testing) Protocol:
   HGT1 (Level 1): Test 2 hours after largest meal of day once monthly

   HGT2 (Level 2): Test 2 hours after largest meal of day once weekly

   HGT3 (Level 3): Test 2 hours after largest meal of day for 5 days and send in numbers.
   After initial assessment, test 2 hours after largest meal of day once weekly.

 

***Ketosis symptoms: vomiting, nausea, abdominal pain, Kussmaul breathing, altered mental
   status. If concern for ketosis, check urine or blood ketones if able, if positive or unable to test
   refer for urgent evaluation at ED.

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