Oral Glucose

Tolerance Test
By
Abdulaziz Massoud Alfaydi
 Oral Glucose
Tolerance Test ( OGTT )
Definition.
Procedure.
Curves.
Different Types Explain.
 DEFINITION
The Term Diabetes Mellitus Describes Several
Diseases Of Abnormal Carbohydrate Metabolism
That Are Characterized By Hyperglycemia.
It Is Associated With A Relative Or Absolute

Impairment In Insulin Secretion, Along With

Varying Degrees Of Peripheral Resistance To
The Action Of Insulin.
CONTINUED

.The
Glucose Tolerance Test (GTT) Consists Of
Drinking (75 To 100 )Grams Of Glucose Solution .
.Measuring The Blood Glucose Values Every Hour

To
Get A Curve .

.A 2 Hour GTT Is Used To Diagnosis Diabetes , But A

6 Hour Test Might Also Diagnosis Diabetes Plus

Hypoglycemia.
.Symptoms Of Hypoglycemia Occur After The 5 Th

Hour.
.In Healthy Individual The Insulin Response To A
 Terminology


Normoglycemia - Fasting Blood Glucose 75-
100mg/dL.
Impaired Glucose Tolerance: 110-126mg/dL.
Hyperglycemia : >126mg/dL.
 ABNORMAL
HYPERGLYCEMIA.
HYPOGLYCEMIA.

10/18/09 6
DIABETES STATUS
MONITORING

A.Conventiona

Glucose-Blood (GOD-POD).
 -Urine.
 Benedict reagent.
 G Y O R
 0.5% 1% 1.5% 2->2%
GTT: 1.Lab-Oral GTT (OGTT).
 2.Clinic-Post-prandial (meal).

7
 Factors affecting GTT
Concerned with the blood glucose regulation:
1.Metabolic-diet-thiamine.
-starvation.
-excretion.
-liver diseases, infection.
2.Hormones-insulin:
 -antagonists.
epinephrine,glucagon,glucocorticoids,GH,
THYROXIN.

8
 Procedure
This Is Timed Test For Glucose Tolerance Hour
Plasma . A-2 Glucose Test Is Done After
Glucose Load To Detect Diabetic Individuals Other

Than Pregnant Women .

The 3- Hour Test Is Done For Pregnant Women

The 4- Hour Test Evaluates Possible Hypoglycemia.


 Continued


1- Have Patient Eat A Diet With >150 g Of

Carbohydrates For 3 Days Before The Test.

Administer 1.75g/Kg Body Weight Oral Glucose

Say Dissolved In 250 ml Of Water

Allow Him To Drink The Glucose Solution Over A

Period Of 5 Minute Time




 DRUGS
2-Ensure That The Following Drugs Are
Discontinued 3 Days Before The Test Because
They May Influence Test Results:
A) Hormones , Oral Contraceptives , Steroids.

B)salicylates, Anti Inflammatory Drugs.

C)diuretic Agents.

D) Hypoglycemic Agents.

.E) Antihypertensive Drugs And Other Drugs As

Advised By The Diabetologist.

 CONTINUED
3-A 5ml Sample Of Venous Blood Is Drawn. The
Patient Should Fast 12 To 16 Hours Before Testing .
4-blood Samples Are Obtained 30 Minutes , 1 Hr,

2hrs, 3hrs After Glucose Ingestion.

5- Specimens Taken 4 Hrs After Ingestion Are

Significant For Detecting Hypoglycemia .

6-Tolerance teste can also be performed for Pentose

,Lactose ,Galactose And D- Xylose.

 Possible
Interpretation
a) Persistent fasting hyperglycemia >140mg/dl Or
>7.8mmol/L.
b) Persistent fasting normal plasma glucose .

c) Patient with overt diabetes mellitus.

d) Persistent 2-hour plasma glucose >200mg/dl Or

>11.1mmol/L.
 Interfering factors
1- Smoking Increases Glucose Levels.
2-altered Diets (Weight Reduction) Before Testing

Can Diminish Carbohydrate Tolerance And Suggest

,False Diabetes.
Glucose Levels Normally Tend To Increase With

Aging.
3-prolonged Oral Contraceptive Use Causes

Significantly Higher Glucose Levels In The Second

Hour Or In Later Blood Specimens.


continued
4-Infections disease illnesses and operative
procedures affect glucose tolerance.

.5- Certain drugs

a) Corticosteroids.

b) Estrogens.

c) Heparin.

d) Nicotinic acid .

e) Phenothiazines.

f) Lithium .
 CONTINUED
STATE NORMAL IMPAIRED DIABETES

Fasting 70-110 110-126 (IFG) >126

2 Hr(mini GTT) 140 140-200(IGT) >200

18
curve according to Seale
Harris

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose 80 90 105 90 80 80 80 80
[mg/dl]
1b. Normal Maximum
curve

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose 120 135 160 130 110 100 110 105
[mg/dl]
diabetes

Time [hours]
0 0.5 1 2 3 4 5 6
Blood glucose[mg/dl] 115 145 180 160 120 130 130 130
 3. Curve with severe
diabetes

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose[mg/dl] 200 235 265 280 300 295 280 270
 4. Diabetes and
hypoglycemia

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose[mg/dl] 100 160 220 160 85 60 50 85

 5. Continuous low
values

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose[mg/dl] 60 80 100 60 60 60 60 55

 6. Pre-hypoglycemia

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose [mg/dl] 90 115 140 100 85 80 70 75
7. Mild hypoglycemia

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose [mg/dl] 80 120 80 60 80 75 80 80
 9. Severe hypoglycemia
II

Time [hours] 00.5 1 2 3 4 5 6

7

Blood glucose [mg/dl] 100 170 110 130 170 125 100
100
10. Flat curve

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose [mg/dl] 90 90 90 100 90 100 80 90

 8. Severe hypoglycemia I

Time [hours] 0 0.5 1 2 3 4 5 6

Blood glucose[mg/dl] 95 110 120 105 100 60 40 60

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