CONFIRMATION
POSITIVE
for 1 Ab
Serum Confirmation
Reference lab: CLIA-approved, ideally IASP participant with using samples from early stage type 1 diabetes able to measure all 4 Ab: GAD64A, IA-2A, Insulin, ZnT8A
a
a
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
a
Higher Intensity follow-up
• Assess/Educate for
symptoms of hyperglycemia
​
• Instruct on SMBG 3
• Referral to pediatric/adult
diabetologist
b
• Evaluate for symptoms of
hyperglycemia and ketosis
• Verbal consult with and urgent
referral to pediatric/adult
diabetologist
c
a Reference lab: CLIA-approved, ideally IASP participant with using samples from early stage type 1 diabetes able to measure all 4 Ab: GAD64A, IA-2A, Insulin, ZnT8A
​
b SMBG (Self-monitored blood glucose) Protocol:
SMBG 1 (Level 1): Test 2 hours after largest meal of day once monthly
SMBG 2 (Level 2): Test 2 hours after largest meal of day once weekly
SMBG 3 (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.
c 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.