#672 Defining Diabetes: Antibody

April 29, 2022Scott Benner

Scott and Jenny Smith define diabetes terms

Scott and Jenny Smith define diabetes terms In this Defining Diabetes episode, Scott and Jenny explain Defining Diabetes: Antibody.

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Scott Benner 0:00
Hello friends, and welcome to episode 672 of the Juicebox Podcast.

On today's episode of The Juicebox Podcast, Jenny Smith and I are going to define antibodies, auto antibodies, antibodies, auto antibodies, antibodies antibodies WHAT THE HELL ARE antibodies antecedent here we go please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise Always consult a physician before making any changes to your health care plan. We're becoming bold with insulin Are you a US resident who has type one diabetes or is the caregiver of someone with type one because if you are, you can support the T one D exchange and research for type one diabetes by going to T one D exchange.org. Forward slash juicebox. When you get there, join the registry fill out the survey the whole thing takes fewer than 10 minutes and you are going to help people with type one. You're also going to support the Juicebox Podcast. I don't even want to stop talking now. My voice sounds amazing in my ears. T one D exchange.org forward slash juicebox this episode of The Juicebox Podcast is sponsored by us med us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor from the pod dash, the number one fastest growing tandem distributor and the number one rated distributor index. com customer satisfaction surveys. US med is a place where you get your diabetes supplies from most of us use them right? Most of us are using some sort of an online Wait a minute, are you not getting your supplies online? Okay, hold on. First of all, it's super easy to get your supplies online. You just are you're not doing this. Alright, hold on a second. Let me get a sip of water I gotta explain this whole thing to you. So we used to use another company, we've actually used a couple of them. And in the past they've been you know, spotty, let's say spotty in their customer service. But us med prides themselves on their white glove treatment of their customers. US med has an A plus rating with the Better Business Bureau and they want you to get better service and better care than you're accustomed to getting now. US med always provides 90 days worth of supplies and fast free shipping. You can get a free benefits check right now at us med.com forward slash juicebox or by calling 888721151. For us Medicare is everything from insulin pumps and diabetes testing supplies to the latest CGM including libre two and Dexcom G six. They accept Medicare nationwide, and over 800 private insurers. This 888 Number is dedicated for Juicebox Podcast listeners. Call now 888-721-1514 Get the service you deserve. Get your supplies without a big hassle. US met us med.com forward slash juicebox. Look, everybody these supplies are going to be common forever and ever. I'd love it if you had it set up so that it just happened and you didn't have to think about it. That's how we have it here. And it is a real it's a weight lifted. It's another thing you don't have to think about. Let us med think about that. You go live your life we've talked about antibodies in thyroid episodes. Yeah, and other places. I am told by Isabel who helps me run the Facebook page that people are confused about antibodies. And she said to me, please do a defining episode about them put it in one place where they can find it. It's easy to understand. And I said okay, as well. I will absolutely do that. Now here comes the problem. I'm still I still get a little confused as well. And I know it's just because I haven't looked at it closely enough. If you said to me right now, what's up? I'm not gonna look at anything. I'm not just gonna go off of what I remember right? Then you're gonna you're gonna tell me if you said to me antibodies in conjunction with type one diabetes

I would say something like, your body has antibodies that are meant to do stuff, fight illness or disease or whatever. And if you have type one diabetes, or if you are predisposed to type one diabetes, there are antibodies in your system that are likely to go get the beta cells in your pancreas at some point, and they don't belong in your body. And I don't know if that's right, that's literally the best I can conjure up out of my mind. Just told

Jennifer Smith, CDE 5:40
me, No, not, I mean, not really wrong, I think it's the way that you think about it or see it, it's, I mean, an antibody in general, whether it's for diabetes, or thyroid or other, you know, issues. an antibody essentially, is just a protein that your immune system uses to essentially take care of a foreign object via a virus or, you know, bacteria or something that's potentially harmful, right? I mean, that's, that's the gist of an antibody. But in someone specifically with type one diabetes, and something in the body triggered an immune response. And so your body, unfortunately, has identified beta cells as the foreign object. So your body produces antibodies to take care of this foreign object, which technically isn't foreign, but for some reason, the body now thinks that it is. So the antibodies are I mean, they're there, they would be identifiable in the bloodstream in a in a blood draw, if you had antibodies that were specifically attacking the beta cells, right. So we can do blood draws to test for antibodies, we can do blood draws to test for insulin antibodies. I mean, one of the very well known ones that most people definitely have done at diagnosis is the GAD antibody. And then, you know, if you've done any testing, or had any family members who have done testing through like TrialNet, or any of those types of places, there are, I think, at least two other antibodies that they're kind of looking for as well, to identify, so in general, an antibody is just it's really supposed to be there. That's something that your body uses. Unfortunately, it becomes something not great, because of the way that your body is identifying the beta cells, which is now seeing as like a foreign invader,

Scott Benner 7:49
okay. So for auto antibodies are markers of beta cell autoimmunity and type one diabetes isolette cell antibodies ICAA against cytoplasmic proteins in the beta cell, antibodies to glutamic acid, well, the carbo laisse which that's the GAD 65, right? Insulin insulin auto antibodies, which are IAEA, and I A to A to protein tyrosine, phosphatase. FOSS. Wow, okay. All right. So not everybody has these, the these like, like, like, let's just take gad as an example, right? Like, if I tested the population, most people would not have that antibody.

Jennifer Smith, CDE 8:36
They shouldn't. I mean, honestly, if you're testing positive for the GAD antibody, it indicates an immune attack, which is really points to type one diabetes specifically. Okay, so general person should not have gad antibody.

Scott Benner 8:50
So if you have it, where do you work? I don't understand where you get it from? Like, how does how does one body Jenny that are we outside of your depth?

Jennifer Smith, CDE 9:01
I don't know. I think if that could be, I don't know if it's out of my depth. It's certainly out of the realm of

Scott Benner 9:09
understanding at this point.

Jennifer Smith, CDE 9:11
I think it's to my like, limited explanation. It would be the reason that there's no

Scott Benner 9:18
cure is because we don't know how that happens. We don't

Jennifer Smith, CDE 9:21
Okay, right. I mean, some other really, really intelligent scientist and because sure could say hey, we're pointing things in this direction or whatever. And I'd be like, Okay, well, that's really fancy.

Scott Benner 9:35
So for reasons that may be at this moment, beyond understanding as a person can develop one or all of these antibodies, and then what you're waiting for next, it's the other shoe to drop it's for you to get ill sick, stressed something, your immune system to be like alright boys, go attack those invaders and they run right past your Your virus and go right into the pancreas and go after your beta cells. And that's

Jennifer Smith, CDE 10:04
why there are and for the GAD, I think I was actually wrong. I think that there are I think there are other autoimmune conditions if I'm not incorrect, I think thyroid, you may have gad antibodies present. Okay. And I am I think there's another autoimmune disorder if I'm correct, that that may be something that would show positive, I would have to again, look that up. But I'm, I'm quite sure gad is also present for thyroid. So anyway, um, you know, in terms of a virus, that's why many people believe that people with type one may have had a virus, which was like a switch. It's like a light switch. i That's kind of how I think about it. My brother probably had the same virus that I had, if the reason that I have type one is from a virus, I don't know why I have type one, I'm quite sure that my brother and I living in the same house probably had the same viruses, why my body decided to interact with that virus and the switch turned on and decided to flip and say, Okay, we've taken care of this. But now we're also seeing these body parts or these pieces of the body of the beta cells as foreign objects to. So why one person versus another? I don't know.

Scott Benner 11:31
Yeah. I would again, I think I've said in other episodes, I don't know for certain, but I would bet money that Arden had Coxsackie virus, and then she got type one. I've heard a lot of people specifically say Coxsackie. And then type one. As a matter of fact, we had the CEO on a prevention bio. Hey, it's Scott, I know I put the ad at the beginning of the episode today. I tricked you a little bit. But I still need to pop in and tell you that US med offers a free benefits check and you can get it at us med.com forward slash juice box, or by calling a special number just for Juicebox Podcast listeners 888-721-1514 us med carries everything from your insulin pumps, to your diabetes testing supplies, go check them out, who was on to talk about Tomislav, which I always mispronounce. And later I will get a message after this goes off where they say you've pronounced it wrong again. But I know that he was talking about how one of the ways that he thought you could significantly cut down on type one diabetes is to inoculate people against coxsackievirus. Yeah. And he said so that to me, I mean, if someone's saying that, then they've seen enough impact that way, but they're saying like, don't get me wrong, like Coxsackie doesn't make type one diabetes. Right. But if you have these auto antibodies, which I'm assuming Arden had, then you get Coxsackie. I'm, I'm thinking what he was saying was that there's more frequency to go from a person who has auto antibodies, who gets Coxsackie to type one, then there is a person who has auto antibodies, and they get the flu, and then they go to type one, etcetera, like something like that. Right. So yeah, there's probably a mechanism in there that I mean, we don't understand. Maybe somebody else does, but and the Coxsackie

Jennifer Smith, CDE 13:31
is certainly one that's well identified. I mean, as you said, you can look for it, you can easily find multiple noted references to Coxsackie and type one. Yeah. But it is also a more of a childhood disease illness. Right? Which then also leads to the questions of, well, if an adult didn't have Coxsackie, then why all of a sudden, is this random adult who has no family history of type one at all? Right? Why is it all of a sudden there?

Scott Benner 14:06
Right? Well, so is it. So let's keep talking about that for a second. It's possible you could have these I mean, it's possible that there are people who live their entire life with these auto antibodies and never get type one diabetes, right. And so, I hear from, I mean, this podcast has allowed me to talk to so many people, that there's no longer an age that I think you can't get type one diabetes after, you know, like, I know that people used to think, you know, it was kind of like that weird slippery slope of, you know, the JDRF was the Juvenile diabetes Research Foundation. So people know that it's juvenile diabetes, you can only get it if you're a kid, obviously wasn't true. But even in my like, you know, uninitiated understanding, if you would have found me before Arden had type one I would have told you like if you can get it like 30 years old, you're not going to get diabetes like type one. Right? And that's how people would think about it in the past.

Jennifer Smith, CDE 15:05
Yeah, I mean, I've worked with people who've been in their 60s, upper 60s, I have one woman who was 71 when she was diagnosed with type one. So, you know, there's still certainly no age that it is not possible.

Scott Benner 15:21
Right now, I think it's point, I want to say 73 is now the oldest person that I've interviewed. Really? Yeah. But I mean, what the hell, you know, right. And talk about, you know, thinking you made it mean, really,

Jennifer Smith, CDE 15:37
this far in life. And this is what I get handed now, like, what

Scott Benner 15:42
the heck is done? You know, I thought I was all good. So I think that, if I go back to what Isabel saying to me, about that people asked about this all the time about the antibodies and not understanding them. That is what I want them to leave this episode understanding is that, you know, first of all, you didn't do anything wrong. Right? That and I think that's, I mean, if we could kind of shift gears away from a more medical to maybe a more psychological for a second. You didn't give your kid type one diabetes? Like, No, you didn't give it to yourself? It's not possible, you know, like, you either have these, these antibodies within your system, or you don't. And like Jenny said earlier, modern medicine can't tell why at this point. And if it was just that you watch the prices write too much, or you you know, you know, or you had too much ice cream or like something like that the things that people knee jerk worry about when it first happens, like, Oh, my God, you know, I mean, you know what I'm saying? Like, people come up to you. Not always, but there are people, a lot of people who have personal experiences where an uninformed person will come up to them and just say, like, What, did you feed that kid? You know, how did you do? Absolutely. Right. And that's a big problem. And then it's a bigger problem if it just happened to you. And you and you don't know that, that that couldn't be the case. Correct. I

Jennifer Smith, CDE 17:08
mean, when I was first diagnosed, my mom's coworker, my mother was a grade school teacher. And one of her co workers said, Well, I and I only her overheard the conversation between my mom and my dad, my mom did not tell this to me directly. But she was telling him that her co worker had said, well, thank goodness, it's just juvenile diabetes, she'll grow out of it. Right. I mean, and again, this was, you know, in the 80s. So clearly, a lot of I mean, this information is still out there. I'm not saying it's not but I mean, that's the misnomer of juvenile diabetes to, it'll be, it'll be over soon. You know, as soon as like, you turn 80. And magically, like, I'm not a juvenile anymore must be gone.

Scott Benner 17:55
Arden diagnosed in 2006. And I've lost count of the amount of people have asked me what age children outgrow it. Right. As if, by the way, have you ever outgrown anything? Like, if you ever heard of like, oh, you know? I don't know. He can't keep he can't process protein. Oh, he'll outgrow that. You don't outgrow? There's in the history of the world. I've never heard anybody say, oh, cancer, don't worry. You'll Yeah, like no one's ever said that. But for some reason, it is a really interesting example of how, how the wording is impactful just by calling it juvenile, you make it feel like once you're an adult, it doesn't exist anymore. Exactly. But I just one, listen, I want people to know that you didn't do anything to cause you're type one. Type one. And and I,

Jennifer Smith, CDE 18:44
you know, the question that I also get kind of along the same line is from a lot of the adults that I work with, who have children, they themselves as an adult have type one. And the question always comes up, either should I get my kids tested? Or how likely is it for my child to get type one? You know, quite honestly, there are statistics, if you really wanted to look things up. You certainly could look up some statistics, but it doesn't necessarily say your child because you have type one is 100% going to have type one too. So in a causative. If you have type one and your child ends up developing type one, likely there's a genetic link there, but you didn't necessarily cause that piece to turn on.

Scott Benner 19:29
Right? Like if you have brown eyes, and you don't like them, and your kid has brown eyes. It's not your fault. Your kid has brown eyes. So it's a genetics work. Yeah. And I understand how people feel like I mean, if I'm being honest with you, I wondered for a really long time what I could have done differently, you know, and so I was a stay at home dad. So I was with art and 24/7 I was the I mean you guys all they'll be fairly well from the podcasts like, I'm the kind of person who would wake up in the morning and be like, Wow, it's warm out getting the car, we're going to the zoo, screw the dishes, you know, like we went every which way. And before I understood these antibodies, I used to think, did I not wash something? Well, did I take her to the wrong place? What if I just wouldn't have gone here? Was it a ball pit that gave her diabetes? Like, before I understood that, in all likelihood, Arden was getting diabetes, you know, whether it was going to be when she was two, or three or four or whatever. It was definitely happening. You know, I don't think that we could have locked Arden in a bubble. And you know what I mean? Like, I don't understand the point of that, right? Like, at some point, let's say that would be true. Let's say that if I, by the way, you're gonna have to be really old for this one. But John Travolta was in a movie called The Boy in the bubble. And

Jennifer Smith, CDE 20:52
I was gonna mention that, like, nobody's gonna know what we're talking about some

Scott Benner 20:55
matter, I'm saying it, okay. It was a TV movie of the week in the 70s. I know, you don't know what a TV movie of the week is, if you're under a certain age, I don't care. John Travolta lived in a bubble. The only way he wasn't gonna die, because the outside world was just gonna, like his body couldn't handle it. You know, eventually he left that bubble, he didn't care. So if my point is that if you've got these auto antibodies, and you're gonna end up with type one diabetes, you're gonna end up with type one diabetes, and you're gonna live with diabetes, because that's, that's the straw you drew, you know, so you can't feel bad about it. I know, it's gonna happen and people are gonna feel guilty, but it's these antibodies fault, not yours.

Jennifer Smith, CDE 21:35
Right. And it's how your body interacts with them, right? Whether your body uses them the way that they're supposed to, to identify truly foreign pieces, objects, you know, viruses in the body. That's their job. That's you want them to be there. That's a really important thing. But sometimes they don't do the right thing.

Scott Benner 21:57
Friendly fire, Jenny. Yeah, right. There you go. Yeah. So oh, this was depressing.

Jennifer Smith, CDE 22:06
Nah, was informative. And I hope it's, I hope it was more, you know, I guess informative in a way. That's more, I guess, understandable.

Scott Benner 22:17
Yeah. No, I appreciate breaking it down. Because it's just like the other defining episodes really, you just make these assumptions that people know what Bolus means. And if they don't, they start forming other thoughts. And if you don't understand what these antibodies are, you could run around your whole life thinking you did something, or I could still think, why didn't I wash? Arden's hands one time, and she was a year old before I did something or I don't know what the hell?

Jennifer Smith, CDE 22:41
So I mean, I've gotten off of the whole, I've had people, I've had friends who who've asked me, Well, why do you think I'm like, I don't think anymore. I, I manage this. And I don't have time to go back and think because it's not going to make a difference. Right? Right. I mean, if it made a difference, in fact, of like proving what happened, and then I could actually move into like solving and having a cure. Awesome. But no,

Scott Benner 23:12
well think of it like this, really. I'll keep this vague, but my son is having a problem with another person. Okay, a person who holds sway over him. And he has, he's a bright kid and a thoughtful kid, and he's a thinker. And he will look at what's happening and break the problem down and say, maybe if I try this, this will allow me to you No, change this, to let this other person see that this isn't the case. Or maybe I can, maybe I can end around them and get around. And I've watched him for years, go over it and over and over and at times, make himself crazy about it. And just the other day, he said to me, there's no path. He's like, I'm not the only one impacting this situation. And no matter what I do, it's not right. It won't work. I have to just accept that this is the reality. And I'm going to go do something else now. And I when he was talking about that, I thought that is how I used to feel about diabetes. I used to think like, maybe I could think my way around it or, you know, at least to give myself comfort. And what I realized is that eventually is that the comfort is knowing that not everybody gets out of this unscathed. And people get things and my kids got an autoimmune problem. And she ended up with type one diabetes. And now we just we choose another path and go live happily on that one. So move on. Yeah, for sure. All right. Well, thank you very much. Yeah, absolutely. Have a good day.

Unknown Speaker 24:50
You too.

Scott Benner 25:00
I want to thank Jenny for being here. Don't forget that Jenny works at integrated diabetes.com. If you'd like to hire her, you can. I like to thank our sponsor today us Med, get your diabetes supplies easily, it doesn't need to be a big hassle. And with us med it won't be check them out and get your free benefits check at us med.com forward slash juice box or by calling 888-721-1514. There are links to us, Matt and all the sponsors in the show notes of your podcast player and at juicebox podcast.com. And don't forget to go take that survey AT T one D exchange.org. Forward slash juicebox. When you support the sponsors, you're supporting the show. At this point, I don't even remember how many defined diabetes episodes there are. But there's got to be more than 40. If you're enjoying them, you can find them at juicebox podcast.com diabetes pro tip.com, or by joining the private Facebook group Juicebox Podcast type one diabetes, and then heading up to the top I want to call it the I always want to use the wrong word. And then I hold on a second I'll tell you what it's called when you get the sort of the Facebook page is a private group. It's really terrific. I think it's got like 24 25,000 members in it right now. And at the top. Not here this there's a feature tab. So you have to answer a couple of questions to get in. But once you're in there, go to that feature tab. And there's a list of all the defining diabetes episodes, all the variables, all the how we eats the Quickstart guides. If you're just starting with the show, the Pro Tip series is a list of popular requested episodes popularly requested episodes if I'm going to use English special episodes, Scott and Jenny's where they're called ask Scott and Jenny people send in questions and Jenny and I answer them a whole bunch of stuff on how to Bolus for fat and protein. I mean, there's a ton here anyway, it's all in that private Facebook group up under the featured tab. This is the part where I say thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Please subscribe and your apps Subscribe and follow follow and subscribe.