CONFIRMATION
POSITIVE
for 1 Ab
Serum Confirmation*
* 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.