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Bartoli, E., G. P. Fra, and G. P. Carnevale Schianca. "The oral glucose tolerance test (OGTT) revisited." European Journal of Internal Medicine 22, no. 1 (February 2011): 8–12. http://dx.doi.org/10.1016/j.ejim.2010.07.008.
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Schwartz, J. G., W. T. Phillips, and B. Aghebat-Khairy. "Revision of the oral glucose tolerance test: a pilot study." Clinical Chemistry 36, no. 1 (January 1, 1990): 125–28. http://dx.doi.org/10.1093/clinchem/36.1.125.
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Abstract Nausea and vomiting have been recurrent problems with the oral glucose tolerance tests (OGTT) used to diagnose diabetes. We believe the nausea is associated with delayed gastric emptying caused by the high osmolarity of the glucose solution. In our pilot study, both the "standard" 100-g glucose OGTT and our new modified (lower osmolar) glucose solution were evaluated. Considerably delayed gastric emptying (along with severe nausea) was consistently noted with the standard OGTT. No nausea and a much more rapid gastric emptying time were recorded when the modified glucose solution was administered. We were able to diagnose diabetes (by using Wilkerson's point system) when our modified OGTT was administered to type 2 diabetics. We plan to develop a more physiological, more reproducible, and better tolerated OGTT to diagnose diabetes more accurately in the general population.
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Dalgård, Christine, Soren Möller, and Kirsten O. Kyvik. "Heritability of Curve Patterns in Oral Glucose Tolerance Test." Twin Research and Human Genetics 23, no. 1 (February 2020): 39–44. http://dx.doi.org/10.1017/thg.2020.3.
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AbstractType 2 diabetes, which is caused by both genetic and environmental factors, may be diagnosed using the oral glucose tolerance test (OGTT). Recent studies demonstrated specific patterns in glucose curves during OGTT associated with cardiometabolic risk profiles. As the relative contribution of genetic and environmental influences on glucose curve patterns is unknown, we aimed to investigate the heritability of these patterns. We studied twins from the Danish GEMINAKAR cohort aged 18–67 years and free from diabetes at baseline during 1997–2000; glucose concentrations were measured three times during a 2-h OGTT. Heterogeneity of the glucose response during OGTT was examined with latent class mixed-effects models, evaluating goodness of fit by Bayes information criterion. The genetic influence on curve patterns was estimated using quantitative genetic modeling based on linear structural equations. Overall, 1455 twins (41% monozygotic) had valid glucose concentrations measured from the OGTT, and four latent classes with different glucose response patterns were identified. Statistical modeling demonstrated genetic influence for belonging to a specific class or not, with heritability estimated to be between 45% and 67%. During ∼12 years of follow-up, the four classes were each associated with different incidence of type 2 diabetes. Hence, glucose response curve patterns associated with type 2 diabetes risk appear to be moderately to highly heritable.
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Ko, Gary T. C., Juliana C. N. Chan, Jean Woo, Edith Lau, Vincent T. F. Yeung, Chun-Chung Chow, and Clive S. Cockram. "The Reproducibility and Usefulness of the Oral Glucose Tolerance Test in Screening for Diabetes and other Cardiovascular Risk Factors." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 35, no. 1 (January 1998): 62–67. http://dx.doi.org/10.1177/000456329803500107.
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We examined the reproducibility of oral glucose tolerance tests (OGTT) using the World Health Organization criterion in 212 Chinese subjects (male 149, female 63) who underwent two 75 g OGTTs within a 6-week period. The overall reproducibility was 65.6% (139/212) of which 74 subjects had normal glucose tolerance, 24 had diabetes and 41 had impaired glucose tolerance (IGT) on two occasions. The subjects were divided into three groups [group 1: normal OGTTs on both occasions ( n = 74); group 2: one abnormal OGTT (either diabetes or IGT ( n = 51); group 3: 2 abnormal OGTTs ( n = 87)]. Subjects in group 1 were younger, had lower blood pressure, body mass index (BMI), waist-to-hip ratio (WHR), fasting and 2 h plasma insulin levels, triglyceride, very — low density lipoprotein and apolipoprotein-B concentrations than both groups 2 and 3. Group 2 had similar characteristics as group 3 except for a lower glycated haemoglobin (HbA1c), fasting and 2 h plasma glucose during the two OGTTs. With receiver operating characteristic curve (ROC) analysis, a HbA1c. of 5.3% gave an optimal sensitivity of 70.7% and specificity of 74.3% to predict diabetes as defined by a 2h plasma glucose value ≥ 11.1 mmol/L in the first OGTT. Of the 212 subjects, 73 had HbA1c ≥ 5.3%. The reproducibility of OGTT was 56.2% for these 73 subjects. With ROC analysis, a BMI of 25 kg/m2 gave an optimal sensitivity of 53.7% and specificity of 56.7% to predict diabetes. For the 36 subjects with BMI ≥ 25 kg/m2, the reproducibility of OGTT was 58.3%. Similarly, for the 140 subjects with WHR ≥ 0.9, the reproducibility of OGTT was 57.9%. These findings confirmed the poor reproducibility of OGTT which was not improved even amongst subjects with high HbA1c, BMI or WHR. Furthermore, subjects with one abnormal OGTT, whether reproducible or not, had a higher cardiovascular risk profile compared to subjects who had two normal OGTTs.
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Anderwald, Christian, Amalia Gastaldelli, Andrea Tura, Michael Krebs, Miriam Promintzer-Schifferl, Alexandra Kautzky-Willer, Marietta Stadler, Ralph A. DeFronzo, Giovanni Pacini, and Martin G. Bischof. "Mechanism and Effects of Glucose Absorption during an Oral Glucose Tolerance Test Among Females and Males." Journal of Clinical Endocrinology & Metabolism 96, no. 2 (February 1, 2011): 515–24. http://dx.doi.org/10.1210/jc.2010-1398.
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abstract Background: Several epidemiological studies revealed sex-specific differences during oral glucose tolerance tests (OGTTs), such as higher prevalence of glucose intolerance (i.e. increased glucose at the end of the OGTT) in females, which was not yet explained. Thus, we aimed to analyze sex-related distinctions on OGTT glucose metabolism, including gut absorption, in healthy humans. Methods: Females (n = 48) and males (n = 26) with comparable age (females, 45 ± 1 yr; males, 44 ± 2 yr) and body mass index (both, 25 ± 1 kg/m2) but different height (females, 166 ± 1 cm; males, 180 ± 2 cm; P < 0.000001), all normally glucose tolerant, as tested by frequently sampled, 3-h (75-g) OGTTs, underwent hyperinsulinemic [40 mU/(min · m2)] isoglycemic clamp tests with simultaneous measurement of endogenous glucose (d-[6,6-2H2]glucose) production (EGP). EGP and glucose disappearance during OGTT were calculated from logarithmic relationships with clamp test insulin concentrations. After reliable model validation by double-tracer technique (r = 0.732; P < 0.007), we calculated and modeled gut glucose absorption (ABS). Results: Females showed lower (P < 0.05) fasting EGP [1.4 ± 0.1 mg/(kg · min)] than males [1.7 ± 0.1 mg/(kg · min)] but comparable whole-body insulin sensitivity in clamp tests [females, 8.1 ± 0.4 mg/(kg · min); males, 8.3 ± 0.6 mg/(kg · min)]. Plasma glucose OGTT concentrations were higher (P < 0.04) from 30–40 min in males but from 120–180 min in females. Glucose absorption rates were 21–46% increased in the initial 40 min in males but in females by 27–40% in the third hour (P < 0.05). Gut glucose half-life was markedly higher in females (79 ± 2 min) than in males (65 ± 3 min, P < 0.0001) and negatively related to body height (r = −0.481; P < 0.0001). Conclusions: This study in healthy, glucose-tolerant humans shows for the first time different ABS rates during OGTT in women and men and a negative relationship between body height and gut glucose half-life. Prolonged ABS in females might therefore contribute to higher plasma glucose concentrations at the end of OGTT.
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Solomon, Thomas P. J., Steven K. Malin, Kristian Karstoft, Sine H. Knudsen, Jacob M. Haus, Matthew J. Laye, Maria Pedersen, Bente K. Pedersen, and John P. Kirwan. "Determining pancreatic β-cell compensation for changing insulin sensitivity using an oral glucose tolerance test." American Journal of Physiology-Endocrinology and Metabolism 307, no. 9 (November 1, 2014): E822—E829. http://dx.doi.org/10.1152/ajpendo.00269.2014.
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Plasma glucose, insulin, and C-peptide responses during an OGTT are informative for both research and clinical practice in type 2 diabetes. The aim of this study was to use such information to determine insulin sensitivity and insulin secretion so as to calculate an oral glucose disposition index (DIOGTT) that is a measure of pancreatic β-cell insulin secretory compensation for changing insulin sensitivity. We conducted an observational study of n = 187 subjects, representing the entire glucose tolerance continuum from normal glucose tolerance to type 2 diabetes. OGTT-derived insulin sensitivity (SI OGTT) was calculated using a novel multiple-regression model derived from insulin sensitivity measured by hyperinsulinemic euglycemic clamp as the independent variable. We also validated the novel SI OGTT in n = 40 subjects from an independent data set. Plasma C-peptide responses during OGTT were used to determine oral glucose-stimulated insulin secretion (GSISOGTT), and DIOGTT was calculated as the product of SI OGTT and GSISOGTT. Our novel SI OGTT showed high agreement with clamp-derived insulin sensitivity (typical error = +3.6%; r = 0.69, P < 0.0001) and that insulin sensitivity was lowest in subjects with impaired glucose tolerance and type 2 diabetes. GSISOGTT demonstrated a significant inverse relationship with SI OGTT. GSISOGTT was lowest in normal glucose-tolerant subjects and greatest in those with impaired glucose tolerance. DIOGTT was sequentially lower with advancing glucose intolerance. We hereby derive and validate a novel OGTT-derived measurement of insulin sensitivity across the entire glucose tolerance continuum and demonstrate that β-cell compensation for changing insulin sensitivity can be readily calculated from clinical variables collected during OGTT.
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Albai, Oana, and Romulus Timar. "The Relationship Between 1 Hour Glycemia, During Oral Glucose Tolerance Test and Cardiometabolic Risk." Romanian Journal of Diabetes Nutrition and Metabolic Diseases 19, no. 1 (January 1, 2012): 25–31. http://dx.doi.org/10.2478/v10255-012-0004-6.
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The Relationship Between 1 Hour Glycemia, During Oral Glucose Tolerance Test and Cardiometabolic RiskBackground Diabetes mellitus is a very common disease, worldwide there are currently over 366 million diabetics. It seems that people with normal glucose tolerance and blood glucose at 1 hour during OGTT ≥200mg% represent an intermediate phenotype of abnormal glucose metabolism, another disturbance of carbohydrate metabolism that is associated with increased cardiometabolic risk. Objectives Starting from these premises, we decided to analyze the subjects with glucose at 1 hour during OGTT ≥200mg%, but with normal values for fasting glucose and 2 hours glucose. In this subgroup of subjects some parameters of CMR were analyzed. We also performed a comparison of this subgroup of subjects with both normal glucose tolerance and 1-hour glucose <200mg%, and with those with abnormal glucose tolerance. Results According to currently used recommendations to diagnose diabetes mellitus, from the 778 people included in this study, 167 (21.5%) had disturbances of carbohydrate metabolism, being classified as patoglycemic and 611 persons (78.5%) had normal values of fasting glucose and 2 hours glucose during OGTT, being considered normoglycemic. From the 611 people who were classified as normal glucose tolerance, based on the currently used criteria for diagnosis of diabetes mellitus, a total of 44 persons (7.2%) had, however, the value of 1-hour glucose during OGTT ≥200mg%, which represents 5.6% of the entire group studied. Conclusions Patients with normal glucose tolerance and glucose ≥200mg% at 1 hour during OGTT represent a new subgroup of impaired glucose tolerance, which requires strict lifestyle advice and possibly pharmacological measures to prevent or delay progression to abnormal glucose tolerance.
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Coriati, Adèle, Belinda Elisha, Sandrine Virassamynaik, Maude Phaneuf, Sophie Ziai, Marie-Soleil Gauthier, and Rémi Rabasa-Lhoret. "Diagnosis of cystic fibrosis-related glucose abnormalities: Can we shorten the standard oral glucose tolerance test?" Applied Physiology, Nutrition, and Metabolism 38, no. 12 (December 2013): 1254–59. http://dx.doi.org/10.1139/apnm-2013-0022.
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Adult patients with cystic fibrosis (APCF) are at high risk of developing impaired glucose tolerance (IGT) and CF-related diabetes (CFRD) and thus an annual screening with a 2-h oral glucose tolerance test (OGTT) is recommended. This population would greatly benefit from a simplified and harmless alternative to the standard OGTT. Thus, we aimed to compare the diagnostic values of HbA1c and glycemias at interval time points during the 2-h OGTT for IGT and CFRD detection in APCF. To do so, we conducted a cross-sectional analysis of 194 APCF with normal fasting plasma glucose values (≤7.0 mmol·L−1) who underwent a 2-h OGTT. Receivers operating characteristic area under the curves (ROC-AUC) were analyzed to assess the diagnostic value of HbA1c and intermediate OGTT glycemias using 2-h OGTT glycemia as reference. For both IGT and CFRD diagnoses, ROC-AUC values obtained from glycemia at 90 min were significantly higher than HbA1c and remaining intermediate glycemias (p < 0.001). The best 90-min OGTT cut-off values for these diagnoses were >9.3 mmol·L−1 (IGT) and ≥11.5 mmol·L−1 (CFRD). A 90-min OGTT glycemia might be a simplified alternative to 2-h OGTT glycemia for earlier glucose tolerance abnormalities diagnosis in APCF. This finding should be confirmed in other APCF cohorts and its predictive value should be established prospectively.
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Boston, Ray C., and Peter J. Moate. "NEFA minimal model parameters estimated from the oral glucose tolerance test and the meal tolerance test." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 295, no. 2 (August 2008): R395—R403. http://dx.doi.org/10.1152/ajpregu.90317.2008.
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The kinetics of nonesterified fatty acid (NEFA) metabolism in humans requires quantification to facilitate understanding of diseases like type 1 and 2 diabetes, metabolic syndrome, and obesity, and the mechanisms underpinning various interventions. Oral glucose tolerance tests (OGTT) and glucose meal tolerance tests (MTT) are potentially useful procedures for enabling quantification of NEFA kinetics because they both cause transitory, but substantial, declines and then rebounds in plasma NEFA concentrations in response to physiologically relevant increases in plasma glucose. The Boston MINIMAL model of NEFA kinetics was developed to analyze data from the intravenous glucose tolerance test (IVGTT), but in this work, we present for the first time its application to modeling NEFA data from both OGTT and MTT studies. This model enables estimation of S FFA (μmol·l−1·min−1) (a parameter describing the maximum rate of lipolysis), and K FFA (%/min) (a parameter related to NEFA oxidation rate). The model could well describe the trajectories of NEFA concentrations following an OGTT ( R 2 in excess of 0.97) but was not as successful with the MTT ( R 2 > 0.65). Model parameters derived from analysis of OGTT and MTT data were well identified with coefficients of variation generally less than 15%. Type 2 diabetes, body mass index, and dietary treatment (high-fat vs. high-glycemic-index diets) were all shown to have significant effects on model parameters. Modeling plasma NEFA concentrations over 24 h has helped to identify and quantify the extent that periprandial NEFA peaks and nocturnal elevation in plasma NEFA can be accounted for by our model.
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Ryan, Joshua, Deepani Siriwardhana, and Samuel D. Vasikaran. "An audit of oral glucose tolerance tests at a large teaching hospital: indications, outcomes and confounding factors." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 46, no. 5 (July 29, 2009): 390–93. http://dx.doi.org/10.1258/acb.2009.008261.
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Background Australian guidelines on the diagnosis of diabetes mellitus (DM) recommend performing an oral glucose tolerance test (OGTT) in people with fasting plasma glucose (FPG) values of 5.5–6.9 mmol/L. Aim To evaluate indications, outcomes and confounding factors of OGTTs performed at a large teaching hospital and to compare them with Australian DM guidelines. Method A retrospective audit of OGTTs performed over an 18-month period in a teaching hospital in a major Australian city. Information gathered included co-morbidities; medications; risk factors for type 2 DM; indication for OGTT; results of OGTT and previous glucose tests. Results All 129 OGTTs identified were included in the audit. Eighty-nine (69%) were male, with a median age of 57 years (range 19–86), and 3% were of Australian Aboriginal ethnicity. An indication for OGTT was identified in 93%, including FPG 5.5–6.9 mmol/L (36%) and random plasma glucose (RPG) 5.5–11.0 mmol/L (19%). Other indications for OGTT identified included polycystic ovary syndrome or metabolic syndrome (8%), peripheral neuropathy (3%) and as part of a research protocol (12%). Forty-two (35%) were inpatients at the time of OGTT, of which 35 (30%) were admitted for acute medical or surgical illnesses such as stroke. Nineteen percent were taking medications known to affect plasma glucose (e.g. oral corticosteroids). Conclusion Only 55% of OGTTs had a previous FPG or RPG value warranting OGTT using current Australian DM guidelines. Other valid indications for OGTT were identified in the majority of the remainder. In addition, 41% were performed in the presence of confounding factors (such as acute illness or medications known to affect plasma glucose). Many of the OGTTs that are currently being performed are in the presence of confounding factors that could cause misleading results.
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Graham, Terry E., Premila Sathasivam, Mary Rowland, Natasha Marko, Felicia Greer, and Danielle Battram. "Caffeine ingestion elevates plasma insulin response in humans during an oral glucose tolerance test." Canadian Journal of Physiology and Pharmacology 79, no. 7 (July 1, 2001): 559–65. http://dx.doi.org/10.1139/y01-026.
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We tested the hypothesis that caffeine ingestion results in an exaggerated response in blood glucose and (or) insulin during an oral glucose tolerance test (OGTT). Young, fit adult males (n = 18) underwent 2 OGTT. The subjects ingested caffeine (5 mg/kg) or placebo (double blind) and 1 h later ingested 75 g of dextrose. There were no differences between the fasted levels of serum insulin, C peptide, blood glucose, or lactate and there were no differences within or between trials in these measures prior to the OGTT. Following the OGTT, all of these parameters increased (P [Formula: see text] 0.05) for the duration of the OGTT. Caffeine ingestion resulted in an increase (P [Formula: see text] 0.05) in serum fatty acids, glycerol, and plasma epinephrine prior to the OGTT. During the OGTT, these parameters decreased to match those of the placebo trial. In the caffeine trial the serum insulin and C peptide concentrations were significantly greater (P [Formula: see text] 0.001) than for placebo for the last 90 min of the OGTT and the area under the curve (AUC) for both measures were 60 and 37% greater (P [Formula: see text] 0.001), respectively. This prolonged, increased elevation in insulin did not result in a lower blood glucose level; in fact, the AUC for blood glucose was 24% greater (P = 0.20) in the caffeine treatment group. The data support our hypothesis that caffeine ingestion results in a greater increase in insulin concentration during an OGTT. This, together with a trend towards a greater rather than a more modest response in blood glucose, suggests that caffeine ingestion may have resulted in insulin resistance.Key words: adenosine, skeletal muscle, methylxanthines, glucose uptake, diabetes.
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Flores-Arguedas, Hugo, and Marcos A. Capistrán. "Bayesian analysis of Glucose dynamics during the Oral Glucose Tolerance Test (OGTT)." Mathematical Biosciences and Engineering 18, no. 4 (2021): 4628–47. http://dx.doi.org/10.3934/mbe.2021235.
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Yadav, Manisha, and Gehanath Baral. "One step oral glucose challenge test as screening and diagnostic test for Gestational Diabetes Mellitus." Nepal Journal of Obstetrics and Gynaecology 14, no. 2 (December 31, 2019): 42–45. http://dx.doi.org/10.3126/njog.v14i2.28440.
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Aim: The Diabetes in Pregnancy Study Group of India (DIPSI, 2010) guidelines recommend the non-fasting 75-g oral glucose challenge test (OGCT) as a single-step screening and diagnostic test for gestational diabetes mellitus (GDM). The aim of this study was to assess the validity of DIPSI criteria by comparing with the World Health Organization (WHO) 1999 criteria of diagnosing GDM.
Methods: This study was a hospital based prospective comparative study conducted among 282 pregnant women, of gestational age of 24-28 weeks attending antenatal OPD of Patan hospital. The OGCT was performed on them irrespective of fasting state and without any dietary preparation and they were again asked to come after 3 days of unrestricted carbohydrate diet in fasting state for WHO 2-hour oral glucose tolerance test (OGTT) with 75 gram of glucose load. The value of OGCT >140 mg/dl is diagnostic of GDM (DIPSI 2010). For the reliability of this test, it was compared with WHO 2-hour OGTT.
Results: Among the study population, the mean age and BMI was 26.04±4.50 and 24.08±3.30 respectively. Out of 282 patients, 8 cases (2.83%) were found to have abnormal non-fasting 75-g OGCT and 4 cases (1.41%) had abnormal WHO 2-hour OGTT. Paired t test was employed to examine the difference of blood glucose level of the tests. There was statistically significant difference (p<0.001) between the tests. The Sensitivity, specificity, positive predictive value and negative predictive value of oral glucose challenge test was 25%, 97.48%, 12.5% and 98.90% respectively. The non- fasting 75-g OGCT was able to detect only 25% of the cases.
Conclusions: Though the non-fasting 75-g OGCT test is cost effective and more compliant to pregnant women, the present report suggests that it cannot be used as a single step screening and diagnostic test because of its low sensitivity. However, it is an adequate alternative for screening test in resources limited areas.
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Tura, Andrea, Umberto Morbiducci, Stefano Sbrignadello, Yvonne Winhofer, Giovanni Pacini, and Alexandra Kautzky-Willer. "Shape of glucose, insulin, C-peptide curves during a 3-h oral glucose tolerance test: any relationship with the degree of glucose tolerance?" American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 300, no. 4 (April 2011): R941—R948. http://dx.doi.org/10.1152/ajpregu.00650.2010.
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We aimed to analyze the shape of the glucose, insulin, and C-peptide curves during a 3-h oral glucose tolerance test (OGTT). Another aim was defining an index of shape taking into account the whole OGTT pattern. Five-hundred ninety-two OGTT curves were analyzed, mainly from women with former gestational diabetes, with glycemic concentrations characterized by normal glucose tolerance ( n = 411), impaired glucose metabolism ( n = 134), and Type 2 diabetes ( n = 47). Glucose curves were classified according to their shape (monophasic, biphasic, triphasic, and 4/5-phases), and the metabolic condition of the subjects, divided according to the glucose shape stratification, was analyzed. Indices of shape based on the discrete second-order derivative of the curve patterns were also defined. We found that the majority of the glucose curves were monophasic ( n = 262). Complex shapes were less frequent but not rare ( n = 37 for the 4/5-phases shape, i.e., three peaks). There was a tendency toward the amelioration of the metabolic condition for increasing complexity of the shape, as indicated by lower glucose concentrations, improved insulin sensitivity and β-cell function. The shape index computed on C-peptide, WHOSHCP (WHole-Ogtt-SHape-index–C-peptide), showed a progressive increase [monophasic: 0.93 ± 0.04 (dimensionless); 4/5-phases: 1.35 ± 0.14], and it showed properties typical of β-cell function indices. We also found that the type of glucose shape is often associated to similar insulin and C-peptide shape. In conclusion, OGTT curves can be characterized by high variability, and complex OGTT shape is associated with better glucose tolerance. WHOSHCP (WHole-Ogtt-SHape-index) may be a powerful index of β-cell function much simpler than model-based indices.
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Lott, Mary E. J., Cynthia Hogeman, Michael Herr, Robert Gabbay, and Lawrence I. Sinoway. "Effects of an oral glucose tolerance test on the myogenic response in healthy individuals." American Journal of Physiology-Heart and Circulatory Physiology 292, no. 1 (January 2007): H304—H310. http://dx.doi.org/10.1152/ajpheart.00940.2005.
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The myogenic response, the inherent ability of blood vessels to rapidly respond to changes in transmural pressure, is involved in local blood flow autoregulation. Animal studies suggest that both acute hyperglycemia and hyperinsulinemia may impair myogenic vasoconstriction. The purpose of this study was to examine the effects of an oral glucose load on brachial mean blood velocity (MBV) during increases in forearm transmural pressure in humans. Eight healthy men and women (38 ± 5 yr) underwent an oral glucose tolerance test (OGTT). MBV (in cm/s; Doppler ultrasound) responses to a rise in forearm transmural pressure (arm tank suction, −50 mmHg) were studied before and every 30 min for 120 min during the OGTT. Before the start of the OGTT, MBV was lower than baseline values 30 and 60 s after the application of negative pressure. This suggests that myogenic constriction was present. During the OGTT, blood glucose rose from 88 ± 2 to 120 ± 6 mg/dl ( P < 0.05) and insulin rose from 14 ± 1 to 101 ± 32 μU/ml ( P < 0.05). Glucose loading attenuated the reduction in MBV with arm suction (Δ−0.73 ± 0.14 vs. Δ−1.67 ± 0.43 cm/s and Δ−1.07 ± 0.14 vs. Δ−2.38 ± 0.54 cm/s, respectively, during 30 and 60 s of suction postglucose compared with preglucose values; all P < 0.05). We observed no such time effect for myogenic responses during a sham OGTT. In an additional 5 subjects, glucose loading had no effect on brachial diameters with the application of negative pressure. Oral glucose loading leads to attenuated myogenic vasoconstriction in healthy individuals. The role that this diminished postglucose reactivity plays in mediating postprandial hypotension and/or orthostasis needs to be further explored.
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Lizarzaburu-Robles, Juan Carlos, Lizardo Torres-Aparcana, Raúl Mansilla, José Valera, Gabriela Vargas, Flor Vento, José Laca, Víctor Cornetero, and William H. Herman. "A CROSS-SECTIONAL STUDY OF THE ASSOCIATION BETWEEN THE 1-HOUR ORAL GLUCOSE TOLERANCE TEST AND THE METABOLIC SYNDROME IN A HIGH-RISK SAMPLE WITH IMPAIRED FASTING GLUCOSE." Endocrine Practice 26, no. 5 (May 2020): 529–34. http://dx.doi.org/10.4158/ep-2019-0387.
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Objective: The aim of this study was to evaluate the association between the 1-hour oral glucose tolerance test (OGTT) (≥155 mg/dL) and metabolic syndrome (MS) in a sample with previous impaired fasting glucose (IFG). Methods: Three hundred and twenty four Peruvian subjects with a history of IFG ≥100 mg/dL were selected for a cross-sectional study. They underwent a 75 g OGTT and were assigned to different groups according to the result. We evaluated the association between 1-hour OGTT and MS. Results: The mean age was 56.5 ± 12.6 years and 191 (61.5%) were female. During the OGTT, we found 28 (8.6%) subjects with diabetes, 74 (22.8%) with IGT, and 222 (68.5%) with a normal glucose tolerance test with a 2-hour glucose <140 mg/dL (NGT). In the NGT group, 124 (38.3%) had 1-hour glucose levels <155 mg/dL, while 98 (30.2%) had 1-hour glucose levels ≥155 mg/dL. Evaluating the association between the 1-hour value in the OGTT and MS, we found that subjects with a 1-hour glucose ≥155 mg/dL were more than twice as likely to have MS as those with a 1-hour glucose <155 mg/dL (odds ratio = 2.64, 95% confidence interval: 1.52 to 4.57). In addition, body mass index, fasting glycemia, triglycerides, and waist circumferences were significantly higher in subjects with 1-hour glucose levels ≥155 mg/dL compared to those with 1-hour glucose levels <155 mg/dL ( P<.05). Conclusion: Among subjects with IFG, performing an OGTT was helpful to identify subjects with 1-hour glucose levels ≥155 mg/dL and NGT who were significantly more likely to have MS and a worse cardiometabolic risk profile. Abbreviations: AST = aspartate aminotransferase; BMI = body mass index; CI = confidence interval; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; LDL = low-density lipoprotein; MS = metabolic syndrome; NGT = normal glucose tolerance; OGTT = oral glucose tolerance test; OR = odds ratio; T2DM = type 2 diabetes; TG = triglycerides
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Ribeiro-Oliveira, Antônio, Alexander T. Faje, and Ariel L. Barkan. "Limited utility of oral glucose tolerance test in biochemically active acromegaly." European Journal of Endocrinology 164, no. 1 (January 2011): 17–22. http://dx.doi.org/10.1530/eje-10-0744.
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ContextMeasurement of GH after oral glucose tolerance test (OGTT) is used for the diagnosis and surveillance of acromegaly. However, there are major discrepancies between glucose-suppressed GH and plasma IGF1 as indices of biochemical activity of acromegaly in patients with relatively mild GH oversecretion. This study was aimed to assess the performance of OGTT in patients with acromegaly and variable GH outputs.MethodsForty adults with newly diagnosed, untreated acromegaly (15 with GH >4.3 μg/l and 25 with GH <4.3 μg/l) and elevated IGF1 levels were studied. All underwent Q10 min for 24 h sampling for GH followed by an OGTT.ResultsPostglucose nadir GH (GHn) correlated significantly to 24 h GHn, mean 24 h GH, and baseline GH (P<0.001 for all comparisons). GHn correlated significantly to IGF1 z-scores for the ‘low’ GH group and for the entire group (P<0.0001 for both comparisons), but not for the ‘high’ GH group. None of the patients with mean GH >4.3 μg/l had GHn below 1 μg/l. In contrast, 13 out of 25 patients (52%) with GH <4.3 μg/l showed GHn lower than 1 μg/l, and 7 of them (28%) had GHn lower than 0.4 μg/l. These groups did not differ significantly either for average or for maximal GH suppression in OGTT.ConclusionsOur data show that suppressibility of GH by glucose in acromegaly is a function of the degree of GH hypersecretion and that OGTT has only limited diagnostic value in patients with biochemically active acromegaly but only mildly increased GH output.
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Singh, Kavisha, Aniruddha A. Malgaonkar, and Dinesh R. Samel. "A cross-sectional study of impaired glucose tolerance amongst undergraduate medical students." International Journal of Research in Medical Sciences 5, no. 1 (December 19, 2016): 210. http://dx.doi.org/10.18203/2320-6012.ijrms20164551.
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Background: Diabetes is an important chronic disease both in terms of prevalence and associated morbidity and early mortality. Mortality rates in diabetics are two- to threefold higher than those without diabetes. Type 2 Diabetes Mellitus is preceded by a period of abnormal glucose homeostasis and hence early diagnosis is important in decreasing this morbidity and mortality. The oral glucose tolerance test (OGTT) is currently the gold standard for the diagnosis of diabetes.Methods: This cross sectional single observer study was conducted amongst all the undergraduate students and interns of a municipal medical college to assess the point prevalence of impaired glucose tolerance and the factors predisposing to the same. After necessary permissions, participants giving written informed consent were interviewed and participants were subjected to an oral glucose tolerance test (OGTT) and their heights, weights were measured.Results: None of the participants had an increased fasting blood glucose but 30 min, 60 min and 90 min post OGTT blood glucose levels were increased in 9 (11.84%) participants and 120 min post OGTT blood glucose was increased in 15 (19.73%) participants. Increase in Body Mass Index (BMI) shows a positive correlation with fasting (r=0.155) and 120 min post OGTT blood glucose (r=0.042). Increase in weekly junk food servings shows a positive correlation with fasting (r=0.014), 90 min (r=0.004) and 120 min post OGTT blood glucose (r=0.009).Conclusions: Impaired glucose tolerance was present in a substantial number of non-diabetic students and had a correlation with BMI, exercise and junk food intake.
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Berhane, Feven, Alemu Fite, Nour Daboul, Wissam Al-Janabi, Zaher Msallaty, Michael Caruso, Monique K. Lewis, et al. "Plasma Lactate Levels Increase during Hyperinsulinemic Euglycemic Clamp and Oral Glucose Tolerance Test." Journal of Diabetes Research 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/102054.
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Insulin resistance, which plays a central role in the pathogenesis of type 2 diabetes (T2D), is an early indicator that heralds the occurrence of T2D. It is imperative to understand the metabolic changes that occur at the cellular level in the early stages of insulin resistance. The objective of this study was to determine the pattern of circulating lactate levels during oral glucose tolerance test (OGTT) and hyperinsulinemic euglycemic clamp (HIEC) study in normal nondiabetic subjects. Lactate and glycerol were determined every 30 minutes during OGTT and HIEC on 22 participants. Lactate progressively increased throughout the HIEC study period (P<0.001). Participants with BMI < 30 had significantly higher meanM-values compared to those with BMI ≥ 30 at baseline (P<0.05). This trend also continued throughout the OGTT. In addition, those with impaired glucose tolerance test (IGT) had significantly higher mean lactate levels compared to those with normal glucose tolerance (P<0.001). In conclusion, we found that lactate increased during HIEC study, which is a state of hyperinsulinemia similar to the metabolic milieu seen during the early stages in the development of T2D.
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Aekplakorn, Wichai, Valla Tantayotai, Sakawduan Numsangkul, Wilarwan Sripho, Nutchanat Tatsato, Tuanjai Burapasiriwat, Rachada Pipatsart, et al. "Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults." Journal of Diabetes Research 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/396505.
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Aim. To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes.Methods. A total of 6,884 individuals aged 35–65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG.Results. A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes.Conclusion. The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.
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Bonen, Arend, Margaret Ball-Burnett, and Caryl Russel. "Glucose Tolerance Is Improved After Low- and High-Intensity Exercise in Middle-Age Men and Women." Canadian Journal of Applied Physiology 23, no. 6 (December 1, 1998): 583–93. http://dx.doi.org/10.1139/h98-033.
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We compared the effects of low- and high-intensity exercise on oral glucose tolerance immediately and 24 hr after each exercise bout. Participants were 5 male and 5 female individuals (age 40-48). A fasted, oral glucose tolerance test (OGTT) was conducted several days before the first exercise bout. Glucose and insulin concentrations were determined every 15 min throughout a 2 hr, 75 g OGTT. Immediately after low-intensity exercise, the incremental glucose area under the curve was reduced by 16%, compared to the fasting OGTT (p < .05). This was reduced further (−30%) 24 hr postexercise (p < .05). After high-intensity exercise, similar results were observed, with the incremental glucose area reduced by 14 and 35% immediately and 24 hr postexercise, respectively (p < .05). In conclusion, exercise improves glucose tolerance, this effect is more pronounced 24 hr postexercise, and low-and high-intensity exercise provide similar beneficial effects on glucose tolerance. Key words: cycle ergometry, insulin
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Yeckel, Catherine W., Ram Weiss, James Dziura, Sara E. Taksali, Sylvie Dufour, Tania S. Burgert, William V. Tamborlane, and Sonia Caprio. "Validation of Insulin Sensitivity Indices from Oral Glucose Tolerance Test Parameters in Obese Children and Adolescents." Journal of Clinical Endocrinology & Metabolism 89, no. 3 (March 1, 2004): 1096–101. http://dx.doi.org/10.1210/jc.2003-031503.
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Abstract Given the extreme increase in prediabetes, type 2 diabetes, and the potential for metabolic syndrome in obese youth, identifying simplified indexes for assessing stimulated insulin sensitivity is critical. The purpose of this study was validation of two surrogate indexes of insulin sensitivity determined from the oral glucose tolerance test (OGTT): the composite whole body insulin sensitivity index (WBISI) and the insulin sensitivity index (ISI). An obese population (aged 8–18 yr) of normal and impaired glucose tolerance individuals was studied. One group (n = 38) performed both the euglycemic-hyperinsulinemic clamp and OGTT for comparison of insulin sensitivity measurements as well as 1H-magnetic resonance spectroscopy estimates of intramyocellular lipid content. Another larger (n = 368) cohort participated only in an OGTT. Both the WBISI and ISI represented good estimates (r = 0.78 and 0.74; P < 0.0005) for clamp-derived insulin sensitivity (glucose disposed, M-value), respectively. In the large cohort, the surrogate indexes demonstrated the shift toward poorer function and increased risk profile as a function of insulin resistance. Additionally, the WBISI and ISI correlated with intramyocellular lipid content (r = −0.74 and −0.71; P < 0.0001), a tissue marker for insulin resistance. Insulin sensitivity can be estimated using plasma glucose and insulin responses derived from the OGTT in obese youth with normal and impaired glucose tolerance.
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Arthy, S., and I. Arun. "Glycated haemoglobin versus oral glucose tolerance test in screening for gestational diabetes mellitus." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (June 27, 2018): 2888. http://dx.doi.org/10.18203/2320-1770.ijrcog20182901.
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Background: Glycated haemoglobin (HbA1c) has been documented as an easier, useful tool in diagnosis of diabetes and can be considered as a screening tool in GDM as compared to oral glucose tolerance test (OGTT) which has practical constraints like long waiting period in fasting, too many pricks and non-compliance to glucose load solution. The objective of the study was to find out the utility of HbA1c as a diagnostic tool when compared with OGTT in screening of GDM.Methods: A retrospective study was conducted at Sri Venketeswaraa Medical College, Hospital and Research Center, Puducherry including 500 antenatal women attending to the Department of Obstetrics and Gynaecology for their ante-natal checkup during the period from August 2016 to April 2018. HbA1c levels were estimated and ROC curve analysis was done to estimate sensitivity and specificity against gold standard OGTT.Results: The HbA1c levels among the study subjects varied from 4.3% to 8.2%. The mean HbA1c levels among those diagnosed as GDM by gold standard OGTT was 5.82±1.1% and among those without GDM was 5.13±0.7%. The area under the ROC curve was 0.773 (95% CI 0.732–0.814). An HbA1c cut-off value of ≥5.91% had sensitivity of 34.6% and Specificity of 98.2% in diagnosing GDM. An HbA1c cut-off value of ≥5.32% had sensitivity of 84.8% and specificity of 60.1% in diagnosing GDM.Conclusions: HbA1c levels cannot substitute OGTT in diagnosis of GDM. A higher specific cut-off HbA1c value of ≥5.95% is diagnostic of GDM.
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Zhou, Weibin, Yanyun Gu, Hong Li, and Min Luo. "Assessing 1-h plasma glucose and shape of the glucose curve during oral glucose tolerance test." European Journal of Endocrinology 155, no. 1 (July 2006): 191–97. http://dx.doi.org/10.1530/eje.1.02188.
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Objective: To assess the cutoff values at different time points for impaired glucose regulation (IGR) and diabetes, the glucose curve and isolated 1-h hyperglycemia were monitored during an oral glucose tolerance test (OGTT). Methods: Two thousand eight hundred and eighty-six subjects (1300 men and 1586 women) were recruited to have an OGTT. Plasma was collected at 0, 30, 60, 120, and 180 min to analyze glucose and insulin. The diagnosis of impaired fasting glucose, impaired glucose tolerance, and diabetes was based on World Health Organization and American Diabetes Association’s criteria. Those with fasting plasma glucose (FPG)<5.6 and 2-h plasma glucose (PG)<7.8, but 1-h PG≥7.8 and <11.1 mmol/l were defined as 1h-High7.8, and those with FPG<7.0 and 2-h PG<11.1, but 1-h PG≥11.1 mmol/l as 1h-High11.1. The cutoff values were calculated by receiver operating characteristic (ROC) curve. The correlation between β-cell function and the area under the curve of glucose (AUCg) and the shape index was analyzed with linear regression. Results: The cutoff values for IGR were 5.6, 9.7, 10.1, 7.8 and 6.1 mmol/l for blood glucose at 0, 30, 60, 120 and 180 min, 24 for AUCg and 1.3 mmol/l for the shape index. The cutoff values for diabetes were 6.8, 11.2, 13, 11.1 and 7 mmol/l for 0, 30, 60, 120 and 180 min, 30.9 for AUCg and 2 mmol/l for the shape index. Both AUCg and the shape index were inversely related to β-cell function. The profiles of glucose and insulin in the subgroup with isolated 1-h hyperglycemia were very different from those seen in subjects with normal glucose tolerance or IGR. Conclusions: The present study provides new information on measures other than the fasting and 2-h PG to evaluate glucose metabolism in vivo and stimulates further research aimed at assessing the value of the OGTT 1-h PG concentration prospectively.
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Lavie, Anat, Larissa Feinmesser, Isca Landesberg, Yariv Yogev, and Sharon Maslovitz. "219: Low 180' glucose level at Oral Glucose Tolerance Test (OGTT)- implications for glucose control." American Journal of Obstetrics and Gynecology 222, no. 1 (January 2020): S152—S153. http://dx.doi.org/10.1016/j.ajog.2019.11.235.
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Geberhiwot, Tarekegn, Angela Haddon, and Mourad Labib. "HbA1c predicts the likelihood of having impaired glucose tolerance in high-risk patients with normal fasting plasma glucose." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 42, no. 3 (May 1, 2005): 193–95. http://dx.doi.org/10.1258/0004563053857950.
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Background: Although the oral glucose tolerance test (OGTT) is the 'gold standard' for diagnosing prediabetes/diabetes, it is inconvenient for the patient and time consuming. The only alternative simple screening test is fasting plasma glucose (FPG). FPG concentrations of >6.0 mmol/L represent prediabetes/diabetes. FPG concentrations of 6.0 mmol/L may be considered 'normal', although some such patients will demonstrate abnormal glucose tolerance when subjected to an OGTT. We have evaluated the use of glycated haemoglobin (HbA1c) as a screening test for diabetes or impaired glucose tolerance (IGT) in patients who have risk factors for diabetes but FPG ≤6.0 mmol/L. Methods and results: A total of 580 patients with at least two risk factors for diabetes underwent an OGTT and HbA1c measurement. In all, 225 patients had a FPG ≤6.0 mmol/L and met the inclusion criteria. Of these, 23.1% ( n=52) had an abnormal OGTT result (45 had IGT and 7 had diabetes). Subjects with abnormal glucose tolerance had a higher percentage of HbA1c than subjects with normal glucose tolerance ( P<0.001). An HbA1c of 5.6% gave an optimal sensitivity of 72% and specificity of 77% to predict a 2 h plasma glucose ≥7.8 mmol/L. Conclusion: The use of FPG concentration followed by selective measurement of HbA1c in patients who are at high risk of developing diabetes may represent a reasonable approach to identifying patients requiring an OGTT.
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Zhao, Xinjie, Andreas Peter, Jens Fritsche, Michaela Elcnerova, Andreas Fritsche, Hans-Ulrich Häring, Erwin D. Schleicher, Guowang Xu, and Rainer Lehmann. "Changes of the plasma metabolome during an oral glucose tolerance test: is there more than glucose to look at?" American Journal of Physiology-Endocrinology and Metabolism 296, no. 2 (February 2009): E384—E393. http://dx.doi.org/10.1152/ajpendo.90748.2008.
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The oral glucose tolerance test (oGTT) is a common tool to provoke a metabolic challenge for scientific purposes, as well as for diagnostic reasons, to monitor the kinetics of glucose and insulin. Here, we aimed to follow the variety of physiological changes of the whole metabolic pattern in plasma during an oGTT in healthy subjects in a nontargeted reversed-phase ultra performance liquid chromatography coupled to electrospray ionization quadrupole time of flight mass spectrometric metabolomics approach. We detected 11,500 metabolite ion masses/individual. Applying multivariate data analysis, four major groups of metabolites have been detected as the most discriminating oGTT biomarkers: free fatty acids (FFA), acylcarnitines, bile acids, and lysophosphatidylcholines. We found in detail 1) a strong decrease of all saturated and monounsaturated FFA studied during the oGTT; 2) a significant faster decline of palmitoleate (C16:1) and oleate (C18:1) FFA levels than their saturated counterparts; 3) a strong relative increase of polyunsaturated fatty acids in the fatty acid pattern at 120 min; and 4) a clear decrease in plasma C10:0, C12:0, and C14:1 acylcarnitine levels. These data reflect the switch from β-oxidation to glycolysis and fat storage during the oGTT. Moreover, the bile acids glycocholic acid, glycochenodeoxycholic acid, and glycodeoxycholic acid were highly discriminative, showing a biphasic kinetic with a maximum of a 4.5- to 6-fold increase at 30 min after glucose ingestion, a significant decrease over the next 60 min followed by an increase until the end of the oGTT. Lysophosphatidylcholines were also increased significantly. The findings of our metabolomics study reveal detailed insights in the complex physiological regulation of the metabolism during an oGTT offering novel perspectives of this widely used procedure.
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Bonetti, Graziella, Davide Giavarina, and Mariarosa Carta. "Clinical impact of citrate-containing tubes on the detection of glucose abnormalities by the oral glucose tolerance test." Diagnosis 6, no. 4 (November 26, 2019): 377–83. http://dx.doi.org/10.1515/dx-2018-0100.
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Abstract Background Plasma glucose levels provide the cornerstone of diabetes evaluation, and so it is crucial that clinical laboratories provide accurate and reliable plasma glucose results. To prevent in vitro glycolysis, citrate is used. Here, we present the first study on the 75-g oral glucose tolerance test (OGTT) using the currently available new citrate-containing tubes in liquid and granular forms and the previous sodium fluoride (NaF) for the diagnosis of carbohydrate metabolism disorders and gestational diabetes mellitus (GDM) according to the American Diabetes Association (ADA) guidelines. Methods The 75-g OGTT was performed in 147 volunteers, 83 of whom were pregnant women. Blood was collected in NaF/K3 ethylenediaminetetraacetic acid (EDTA) and NaF/Na2EDTA/citrate in liquid form in tubes in Brescia and in NaF/K2Ox and NaF/Na2EDTA/citrate in granular form in Vicenza. Glucose was measured within 3–4 h from the OGTT. The mean biases were calculated and compared with the desirable bias (<± 2.1%). Results OGTT glucose concentrations were higher in citrate tubes when compared to NaF-containing tubes. When citrate tubes were used, GDM increased to 12.5 and 11.7% in Brescia and Vicenza, respectively. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) increased to 36.7, 6.7 and 3.4%, respectively, in Brescia. In Vicenza, an increase of 47 and 1.9% in IFG and IGT, respectively, was found. Conclusions OGTT glucose measurement in citrate-containing tubes was shown to be more effective than those containing only NaF in diagnosing carbohydrate disorders. This new glycolysis inhibitor seems to be a necessary preanalytical tool for accurate and reliable plasma glucose results.
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Cai, Xiaoling, Xueyao Han, Xianghai Zhou, Lingli Zhou, Simin Zhang, and Linong Ji. "Associated Factors with Biochemical Hypoglycemia during an Oral Glucose Tolerance Test in a Chinese Population." Journal of Diabetes Research 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/3212814.
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Aim. To find the association between biochemical hypoglycemia on a 2-hour screening oral glucose tolerance test (OGTT) and insulin resistance. Method. Subjects of this study were sampled from the China National Diabetes and Metabolic Disorders Study that was conducted during 2007 and 2008. Blood samples were drawn at 0, 30, and 120 minutes after the glucose load. Biochemical hypoglycemia was defined as 2-hour glucose < 3.0 mmol/l. Results. In total, 26,606 participants were included, and 141 participants were diagnosed with biochemical hypoglycemia on a 2-hour OGTT. Compared to participants with normal glucose tolerance (NGT), participants with biochemical hypoglycemia presented with a younger age, lower BMI, lower levels of fasting glucose, and lower levels of 30-minute and 2-hour OGTT glucose. In terms of insulin resistance, participants with biochemical hypoglycemia showed higher levels of Matsuda ISI. In terms of β-cell function, participants with biochemical hypoglycemia showed higher levels of Stumvoll early and late indexes. A multivariate regression analysis indicated that higher levels of Matsuda ISI and higher levels of Stumvoll early and late indexes were associated with biochemical hypoglycemia independently. Conclusion. This study indicated that biochemical hypoglycemia might be associated with lower levels of insulin resistance but higher levels of β-cell function in a Chinese population.
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Naznin, Lubna, Muhammad Rabiul Hossain, Debashish Saha, Sarmin Sultana, and Mreenal Kanti Sarkar. "Glycemic Effects of Honey Compared to Glucose Using Standard OGTT." Journal of Enam Medical College 7, no. 2 (June 4, 2017): 95–100. http://dx.doi.org/10.3329/jemc.v7i2.32655.
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Background: Honey, though rich in fructose and glucose, had been shown to have plasma glucose lowering effect. It may be as a result of insulin sensitization, enhanced insulin secretion and anti-oxidant activity.Objective: This study was designed to assess the glycemic effects of honey comparing to glucose.Materials and Methods: The study was carried out at Armed Forces Institute of Pathology (AFIP), Dhaka cantonment from September, 2015 to October, 2015 on 35 individuals who reported to AFIP for Oral Glucose Tolerance Test (OGTT). They were categorized to three groups based on OGTT ? Normal, Impaired glucose homeostasis (IGT or IFG), and Diabetes mellitus. On the subsequent day they were subjected to 52 mL honey load (equivalent to 75 gm by weight) to assess plasma glucose level after 1 hour and 2 hours posthoney load state. Student t-test was done to compare between means of plasma glucose level 1 hour after 75 gm glucose load and 1 hour after 75 gm honey load and also between means of plasma glucose level 2 hours after 75 gm glucose load and 2 hours after 75 gm honey load in the same individuals.Results: In all the three groups mean plasma glucose level in post-honey load state was found declined compared to post-glucose load state in both 1 hour and 2 hours specimens of HTT (Honey Tolerance Test) versus OGTT (Oral Glucose Tolerance Test) and this reduction was statistically significant (p<0.05).Conclusion: The study findings provide evidence that honey consumption causes less change in plasma glucose level than the equivalent quantity of oral glucose load regardless of status of glucose homeostasis. Further well designed researches are needed to determine the long term effects and beneficial quantity of honey, particularly in relation to diabetes mellitus.J Enam Med Col 2017; 7(2): 95-100
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Levy, Jonathan, Richard Morris, Margaret Hammersley, and Robert Turner. "Discrimination, adjusted correlation, and equivalence of imprecise tests: application to glucose tolerance." American Journal of Physiology-Endocrinology and Metabolism 276, no. 2 (February 1, 1999): E365—E375. http://dx.doi.org/10.1152/ajpendo.1999.276.2.e365.
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Comparison studies between physiological tests are often unsatisfactory for assessing their ability to distinguish between subjects. We recommend a simple but comprehensive protocol, using duplicate testing, that compares tests using 1) the discriminant ratio (DR) between the underlying between- and within-subject SDs, 2) correlation coefficients adjusted for attenuation due to test imprecision, and 3) unbiased estimation of the underlying linear relationship between test results. The following five alternative methods for assessing glucose tolerance were compared: fasting plasma glucose (FPG) as a single sample or as the mean of three 5-min samples (FPG3); the 1- and 2-h glucose during a low-dose intravenous glucose infusion (CIG); and the 2-h plasma glucose from a 75-g oral glucose tolerance test (OGTT). All tests had similar DRs ranging from 2.6 to 4.2. The adjusted correlation between FPG and CIG tests approached unity, and those between OGTT and other tests were ∼0.9, showing that FPG3provides similar information to the OGTT. FPG concentrations of 6.0 and 7.1 were found equivalent to the 1985 World Health Organization OGTT thresholds for impaired glucose tolerance and diabetes (7.8 and 11.1 mmol/l).
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Shestakova, E. A. "Conformance of the diagnostic criteria for diabetes mellitus estimated from the results of the oral glucose tolerance testsand glycated hemoglobin (HbA1c) level." Problems of Endocrinology 60, no. 1 (February 15, 2014): 36–38. http://dx.doi.org/10.14341/probl201460136-38.
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The study population of 127 patients with type 2 diabetes mellitus (T2DM) risk factors underwent oral glucose tolerance test (OGTT) and HbA1c measurement for diagnostic reasons. HbA1c revealed less diabetic patients than OGTT (31% vs 43%). HbA1c >7% and OGTT were similar in confirming diabetes, but HbA1c <7% suggests the need for OGTT performance to validate the diagnosis.
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De Hert, Marc, Dominique Van Eyck, Linda Hanssens, Hendrik Peuskens, Erik Thys, Martien Wampers, Andre Scheen, and Jozef Peuskens. "Oral glucose tolerance tests in treated patients with schizophrenia." European Psychiatry 21, no. 4 (June 2006): 224–26. http://dx.doi.org/10.1016/j.eurpsy.2005.05.011.
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AbstractObjectiveA recent consensus conference has proposed guidelines for the monitoring for diabetes in patients with schizophrenia and also identifies the need of long-term prospective studies.MethodsA large scale prospective study on metabolic risks of antipsychotic medication is currently ongoing. At baseline, patients get a full laboratory screening, ECG and an oral glucose tolerance test (OGTT). Baseline data on 100 non-diabetic patients at study inclusion and stable on medication for at least 6 months are presented.ResultsGlucose abnormalities are found in 22% of patients at baseline. A monitoring protocol based only on fasting glucose would not have detected 63.6% of these patients with classifiable glucose abnormalities in our sample. Fasting insulin and measures for insulin resistance have a high predictive value for abnormalities late in the OGTT.ConclusionsAlready at baseline, metabolic problems are frequently present in patients with schizophrenia treated with antipsychotics. Adding assessment of fasting insulin in a monitoring protocol improves detection of glucose abnormalities late in an OGTT.
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Tänczer, Timea, Márk M. Svébis, Beatrix Domján, Viktor J. Horváth, and Adam G. Tabák. "The Effect of Prior Gestational Diabetes on the Shape of the Glucose Response Curve during an Oral Glucose Tolerance Test 3 Years after Delivery." Journal of Diabetes Research 2020 (March 5, 2020): 1–8. http://dx.doi.org/10.1155/2020/4315806.
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Objective. Monophasic glucose response (MGR) during an oral glucose tolerance test (OGTT) and gestational diabetes mellitus (GDM) are predictors of type 2 diabetes mellitus (T2DM). We investigated the association between current MGR and (1) glucose tolerance during a pregnancy 3 years before and (2) current glucose tolerance status. We also sought (3) other determinants of MGR. Research Design and Methods. We conducted a nested case-control study of GDM (n=47 early GDM, diagnosed between 16 and 20 weeks of gestation; n=40 late GDM, diagnosed between 24 and 28 weeks of gestation) and matched healthy controls (n=37, normal glucose tolerance during pregnancy) all free from diabetes at follow-up 3.4±0.6 years after delivery. Glucose tolerance was determined by 2-hour 75 g OGTT. Monophasic and biphasic groups were defined based on serum glucose measurements during OGTT. Results. The biphasic group was younger, had lower triglyceride levels and area under the OGTT glucose curve, and was less frequently diagnosed with early GDM (25 vs. 45%, all p<0.05). Women with a biphasic response also tended to have lower systolic blood pressure (p<0.1). No differences were found in fasting and 2-hour glucose and insulin levels, or BMI. According to multiple logistic regression, MGR was associated with prior early GDM (OR 2.14, 95% CI 0.92-4.99) and elevated triglyceride levels (OR 2.28, 95% CI 1.03-5.03/log (mmol/l)). Conclusions. We found that more severe, early-onset GDM was an independent predictor of monophasic glucose response suggesting that monophasic response may represent an intermediate state between GDM and manifest type 2 diabetes.
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Cuschieri, Sarah, Johann Craus, and Charles Savona-Ventura. "The Role of Untimed Blood Glucose in Screening for Gestational Diabetes Mellitus in a High Prevalent Diabetic Population." Scientifica 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/3984024.
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Global prevalence increase of diabetes type 2 and gestational diabetes (GDM) has led to increased awareness and screening of pregnant women for GDM. Ideally screening for GDM should be done by an oral glucose tolerance test (oGTT), which is laborious and time consuming. A randomized glucose test incorporated with anthropomorphic characteristics may be an appropriate cost-effective combined clinical and biochemical screening protocol for clinical practice as well as cutting down on oGTTs. A retrospective observational study was performed on a randomized sample of pregnant women who required an OGTT during their pregnancy. Biochemical and anthropomorphic data along with obstetric outcomes were statistically analyzed. Backward stepwise logistic regression and receiver operating characteristics curves were used to obtain a suitable predictor for GDM without an oGTT and formulate a screening protocol. Significant GDM predictive variables were fasting blood glucose (p=0.0001) and random blood glucose (p=0.012). Different RBG and FBG cutoff points with anthropomorphic characteristics were compared to carbohydrate metabolic status to diagnose GDM without oGTT, leading to a screening protocol. A screening protocol incorporating IADPSG diagnostic criteria, BMI, and different RBG and FBG criteria would help predict GDM among high-risk populations earlier and reduce the need for oGTT test.
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Schiaffini, Riccardo, Claudia Brufani, Beatrice Russo, Danilo Fintini, Antonella Migliaccio, Lia Pecorelli, Carla Bizzarri, Vincenzina Lucidi, and Marco Cappa. "Abnormal glucose tolerance in children with cystic fibrosis: the predictive role of continuous glucose monitoring system." European Journal of Endocrinology 162, no. 4 (April 2010): 705–10. http://dx.doi.org/10.1530/eje-09-1020.
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A long pre-diabetic phase of abnormal glucose tolerance is described in subjects with cystic fibrosis (CF) since childhood.ObjectiveThe aims of the study were to compare oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS) in the diagnosis of altered glucose metabolism, and to longitudinally evaluate the role of CGMS in predicting glucose metabolism deterioration in children with CF.MethodsSeventeen children with CF and 14 controls were enrolled (mean age 13.3±3.0 years). All subjects underwent OGTT and CGMS registration. On the basis of OGTT, children were classified as normal glucose tolerance, impaired glucose tolerance (IGT), IGT plus at least one glucose value above 200 mg/dl at intermediate OGTT points (IGT+200) and CF-related diabetes (CFRD). HbA1c, glucose area under the curve, insulin sensitivity, and insulinogenic and disposition indexes were also considered. Subjects with CF underwent another OGTT after 2.5 years.ResultsBaseline OGTT revealed 3/17 (7.6%) children with CF with at least one glucose value above 200 mg/dl (1 CFRD and 2 IGT+200), while CGMS revealed 6/17 (35.3%) children with glucose excursions above 200 mg/dl (P=0.010). None of the controls showed glucose over 200 mg/dl either at OGTT or at CGMS. At the 2.5-year follow-up OGTT, all the six subjects who had diabetic glucose excursion (i.e. >200 mg/dl) at baseline CGMS presented IGT+200 or CFRD. In logistic regression analysis, CGMS diabetic excursion was the strongest predictor of IGT+200 and CFRD (P<0.001).ConclusionsCGMS could be a useful tool to predict glucose metabolism derangements in children affected by CF.
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Muscelli, Elza, Andrea Mari, Andrea Natali, Brenno D. Astiarraga, Stefania Camastra, Silvia Frascerra, Jens J. Holst, and Ele Ferrannini. "Impact of incretin hormones on β-cell function in subjects with normal or impaired glucose tolerance." American Journal of Physiology-Endocrinology and Metabolism 291, no. 6 (December 2006): E1144—E1150. http://dx.doi.org/10.1152/ajpendo.00571.2005.
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The mechanisms by which the enteroinsular axis influences β-cell function have not been investigated in detail. We performed oral and isoglycemic intravenous (IV) glucose administration in subjects with normal (NGT; n = 11) or impaired glucose tolerance (IGT; n = 10), using C-peptide deconvolution to calculate insulin secretion rates and mathematical modeling to quantitate β-cell function. The incretin effect was taken to be the ratio of oral to IV responses. In NGT, incretin-mediated insulin release [oral glucose tolerance test (OGTT)/IV ratio = 1.59 ± 0.18, P = 0.004] amounted to 18 ± 2 nmol/m2 (32 ± 4% of oral response), and its time course matched that of total insulin secretion. The β-cell glucose sensitivity (OGTT/IV ratio = 1.52 ± 0.26, P = 0.02), rate sensitivity (response to glucose rate of change, OGTT/IV ratio = 2.22 ± 0.37, P = 0.06), and glucose-independent potentiation were markedly higher with oral than IV glucose. In IGT, β-cell glucose sensitivity (75 ± 14 vs. 156 ± 28 pmol·min−1·m−2·mM−1 of NGT, P = 0.01) and potentiation were impaired on the OGTT. The incretin effect was not significantly different from NGT in terms of plasma glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide responses, total insulin secretion, and enhancement of β-cell glucose sensitivity (OGTT/IV ratio = 1.73 ± 0.24, P = NS vs. NGT). However, the time courses of incretin-mediated insulin secretion and potentiation were altered, with a predominance of glucose-induced vs. incretin-mediated stimulation. We conclude that, under physiological circumstances, incretin-mediated stimulation of insulin secretion results from an enhancement of all dynamic aspects of β-cell function, particularly β-cell glucose sensitivity. In IGT, β-cell function is inherently impaired, whereas the incretin effect is only partially affected.
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Khan, Kalimuddin, Sudip Saha, Partha Pratim Pal, Aparajita Bera, and Shyama Birua. "Study on Association of Serum Ferritin With Thyroid Profile And Oral Glucose Tolerance Test in Thalassemia Major Children." Journal of Nepal Paediatric Society 40, no. 1 (August 10, 2020): 34–40. http://dx.doi.org/10.3126/jnps.v40i1.28472.
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Introduction: The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients. Our objective was to study the association of serum ferritin level with thyroid dysfunctions; abnormal blood glucose tolerance and to see if they appear in the earlier period of life.
Methods: This cross-sectional study was done among thalassemia major children of two to 12 years in a tertiary care hospital, Kolkata, India. A pre-designed proforma was filled. Serum ferritin, fT4, TSH level, and oral glucose tolerance test (OGTT) were measured at presentation and noted in proforma.
Results: A total of 80 thalassemic children were studied. Fiftieth percentile cut off value (1414 ng/ml) of serum ferritin was found to be significant with associated variables like normal fT4, TSH, and OGTT. Out of all study subjects, 39 (51.3%) of normal fT4, 39 (54.9%) of normal TSH and 39 (52.0%) of normal OGTT had ferritin < 50th percentile (P < 0.05). Nine (11.3%) children had abnormal thyroid profiles and five (6.3%) children had abnormal OGTT having ferritin > 2000 ng/ml. At a cut off value of ferritin level > 1414 ng/ml, fT4, TSH and OGTT showed significant abnormality (p < 0.05 with df 1).
Conclusions: Ferritin is a good indirect marker to assess the risk of endocrine abnormality in thalassemic children. Frequent monitoring should be done once ferritin level crosses 1000 ng/ml. This will help in early detection and timely management of thalassemia related endocrinopathies.
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Poon, Sarah Wing-Yiu, Wilfred Hing-Sang Wong, Anita Man-Ching Tsang, Grace Wing-Kit Poon, and Joanna Yuet-Ling Tung. "Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children." Journal of Pediatric Endocrinology and Metabolism 34, no. 7 (April 19, 2021): 877–84. http://dx.doi.org/10.1515/jpem-2020-0689.
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Abstract Objectives Fasting plasma glucose or oral glucose tolerance test (OGTT) is the traditional diagnostic tool for type 2 diabetes (T2DM). However, fasting is required and implementation in all overweight/obese subjects is not practical. This study aimed to formulate a clinical pathway to stratify subjects according to their risk of abnormal OGTT. Methods This retrospective study included patients with overweight or obesity who had undergone OGTT in a tertiary paediatric unit from 2012 to 2018. The optimal haemoglobin A1c (HbA1c) cutoff that predicts abnormal OGTT was evaluated. Other non-fasting parameters, in combination with this HbA1c cutoff, were also explored as predictors of abnormal OGTT. Results Three hundred and thirty-two patients (boys: 54.2%, Chinese: 97.3%) were included for analysis, of which, 272 (81.9%) patients had normal OGTT while 60 (18.0%) patients had abnormal OGTT (prediabetes or T2DM). Optimal HbA1c predicting abnormal OGTT was 5.5% (AUC 0.71; sensitivity of 66.7% and specificity of 71%). When HbA1c≥5.5% was combined with positive family history and abnormal alanine transaminase (ALT) level, the positive predictive value for abnormal OGTT was increased from 33.6 to 61.6%. Conclusions HbA1c, family history of T2DM and ALT level could be used to derive a clinical pathway to stratify children who have high risk of abnormal OGTT.
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Kilberg, Marissa J., Clea Harris, Saba Sheikh, Darko Stefanovski, Marina Cuchel, Christina Kubrak, Denis Hadjiliadis, Ronald C. Rubenstein, Michael R. Rickels, and Andrea Kelly. "Hypoglycemia and Islet Dysfunction Following Oral Glucose Tolerance Testing in Pancreatic-Insufficient Cystic Fibrosis." Journal of Clinical Endocrinology & Metabolism 105, no. 10 (July 16, 2020): 3179–89. http://dx.doi.org/10.1210/clinem/dgaa448.
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Abstract Context Oral glucose tolerance test (OGTT)-related hypoglycemia is common in pancreatic-insufficient cystic fibrosis (PI-CF), but its mechanistic underpinnings are yet to be established. Objective To delineate the mechanism(s) underlying OGTT-related hypoglycemia. Design and Setting We performed 180-minute OGTTs with frequent blood sampling in adolescents and young adults with PI-CF and compared results with those from a historical healthy control group. Hypoglycemia (Hypo[+]) was defined as plasma glucose <65 mg/dL. We hypothesized that CF-Hypo[+] would demonstrate impaired early phase insulin secretion and persistent late insulin effect compared with control-Hypo[+], and explored the contextual counterregulatory response. Main Outcome Measure OGTT 1-hour and nadir glucose, insulin, C-peptide, and insulin secretory rate (ISR) incremental areas under the curve (AUC) between 0 and 30 minutes (early) and between 120 and 180 minutes (late), and Δglucagon120-180min and Δfree fatty acids (FFAs)120-180min were compared between individuals with CF and control participants with Hypo[+]. Results Hypoglycemia occurred in 15/23 (65%) patients with CF (43% female, aged 24.8 [14.6-30.6] years) and 8/15 (55%) control participants (33% female, aged 26 [21-38] years). The CF-Hypo[+] group versus the control-Hypo[+] group had higher 1-hour glucose (197 ± 49 vs 139 ± 53 mg/dL; P = 0.05) and lower nadir glucose levels (48 ± 7 vs 59 ± 4 mg/dL; P < 0.01), while insulin, C-peptide, and ISR-AUC0-30 min results were lower and insulin and C-peptide, and AUC120-180min results were higher (P < 0.05). Individuals with CF-Hypo[+] had lower Δglucagon120-180min and ΔFFA120-180min compared with the control-Hypo[+] group (P < 0.01). Conclusions OGTT-related hypoglycemia in PI-CF is associated with elevated 1-hour glucose, impaired early phase insulin secretion, higher late insulin exposure, and less increase in glucagon and FFAs. These data suggest that hypoglycemia in CF is a manifestation of islet dysfunction including an impaired counterregulatory response.
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Ahmad, Mian Sajjad, Somia Iqtadar, Sami Ullah Mumtaz, Zafar Niaz, Iqra Waheed, and Sajid Abaidullah. "Frequency of Impaired Glucose Tolerance in Obese Patients." Annals of King Edward Medical University 23, no. 4 (February 21, 2018): 546–49. http://dx.doi.org/10.21649/akemu.v23i4.2202.
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Obesity is a state of excess body adipose tissue. Impaired glucose tolerance is a risk factor for developing diabetes Mellitus & is associated with hyperglycemia and insulin resistance. To determine the frequency of impaired glucose tolerance in obese patients. This Cross Sectional study was carried out in North Medical Ward, King Edward Medical University/ Mayo Hospital Lahore for 6 months i.e. January to June 2014. Total 160 obese patients visiting outpatient department of North Medical Ward, Mayo Hospital Lahore for 6 months were included by non-probability purposive sampling. Patients aged 15-70 years of either gender were included. Oral glucose tolerance (OGTT) was done in each patient with unrestricted carbohydrate diet for three days and avoiding coffee, smoking and heavy exercise six hours before the test. Fasting sample was taken then 75g oral glucose was given. Sample after two hours was sent to KEMU clinical lab. A positive result of the patient was labeled as IGT. The patients mean age was 46.3±13.4 years. Out of 160 patients, 78 (48.8%) were males and 82 (51.2%) females.116 (72.5%) patients were obese grade 1 and 44 (27.5%) patients were obese grade 2. The mean BMI (Normal BMI=18.5-22.9kg/m2) of the patients came out to be 29.1±13.6 kg/m2.There were 116 (72.5%) patients of obese-1 and 44 (27.5%) patients of obese 2. There were 140 (87.5%) patients normal and 20 (12.5%) patients were impaired OGTT. In obese-1 type patients, 112 (70%) patients had normal OGTT and 4 (2.5%) patients had impaired OGTT. In the obese-2 type patients, 28 (17.5%) patients had normal OGTT and 16 (10%) patients had impaired. Impaired glucose tolerance is commonly found in obese patients.Therefore adequate measures like dietary restrictions, physical exercise & drugs should be taken to control obesity.
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Mohanapu, Swarnalatha, and Abinaya Maathuri Jayakumar. "Prevalence of glucose abnormalities in polycystic ovary syndrome women and evaluating the efficacy of fasting blood glucose in detecting these glucose abnormalities compared to glucose tolerance test." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 5 (April 29, 2019): 1751. http://dx.doi.org/10.18203/2320-1770.ijrcog20191544.
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Background: Polycystic ovarian syndrome (PCOS) is the most commonly prevalent endocrinopathy of reproductive age women. It is a significant public health issue with reproductive, metabolic and psychological features. Because patients with PCOS are at high risk for developing glucose abnormalities, the early identification of affected patients and institution of life style changes or pharmacological treatment may help reduce the long-term risks associated with PCOS. This study was done to assess the prevalence of glucose abnormalities and to evaluate the efficacy of Fasting blood glucose (FBG) in detecting glucose abnormalities when compared to 2 hrs oral glucose tolerance test (OGTT).Methods: Hospital based cross sectional study carried out in 300 women diagnosed as PCOS according to Rotterdam criteria. In patients diagnosed as PCOS, Fasting Blood Glucose and OGTT were done. OGTT taken as an accurate test and FBG values compared with OGTT values to evaluate the efficacy of FBG. Prevalence of glucose abnormalities and association with age, BMI and clinical features was evaluated.Results: Glucose abnormalities were detected in 69 (23%) women with 2 hours OGTT, but with FBG only in 49 (16.33%) women, around one third of women were missed. Sensitivity of FBG was 71.01% (95% CI 58.84% to 81.31%). Mean age of women with abnormal OGTT (27.99) was significantly higher than the women with normal OGTT (24.7). Mean BMI of women with abnormal OGTT (27.42) was significantly higher than the Mean BMI of women with normal OGTT (23.36).Conclusions: Sensitivity of FBG was low in detecting glucose abnormalities. Increasing age, increase in a BMI, menstrual abnormalities, hirsutism/acne and family history of diabetes appear to have positive linear correlation with prevalence of glucose abnormalities.
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IKRAM, M., SYED HAIDER HASAN ALAM, SHAFQAT MUKHTAR, and M. Saeed. "GESTATIONAL DIABETES MELLITUS." Professional Medical Journal 19, no. 04 (August 7, 2012): 462–68. http://dx.doi.org/10.29309/tpmj/2012.19.04.2258.
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Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.
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Odrowąż-Sypniewska, Grażyna. "Laboratorydiagnosis of prediabetes." Diagnostyka Laboratoryjna 52, no. 1 (April 18, 2016): 57–62. http://dx.doi.org/10.5604/01.3001.0009.3632.
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Prediabetes is the term used to describe the condition with impaired fasting glucose (IFG), glucose concentrations higher than normal but below the established threshold for diabetes, or impaired glucose tolerance (IGT) recognized based on the results of a 2-hour oral glucose tolerance test (OGTT). People with prediabetes are at high-risk for developing diabetes and associated complications. Occurrence of IFG and/or IGT is associated with abdominal or visceral obesity, high serum triglycerides and/or low HDL-cholesterol, hypertension. From the practical point of view, screening with HbA1c is easier to perform however, it was suggested that fewer cases of prediabetes are detected than with OGTT. It may be understandable as both measurements reflect different physiological processes. In the above presented studies the performance of hemoglobin A1c, advocated for the diagnosis of diabetes and prediabetes, has been assessed in corroboration with fasting plasma glucose (FPG) or with the combination of FPG and 2-hr OGTT glucose values. It is important to point out that HbA1c below 5.7% do not reliably exclude the presence of prediabetes. The above presented data support the idea for greater use of oral glucose tolerance tests in combination with FPG for diagnosis of dysglycemia.
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Manell, Elin, Patricia Hedenqvist, and Marianne Jensen-Waern. "Training Pigs for Oral Glucose Tolerance Test—Six Years’ Experience of a Refined Model." Animals 11, no. 6 (June 4, 2021): 1677. http://dx.doi.org/10.3390/ani11061677.
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Animal models of human diseases are important in biomedical research. When using animals for scientific purposes, the 3Rs (replace, reduce, refine) should be considered. Refinement of animal models is essential to ensure best use of animals, which is important for ethical reasons and to retrieve reliable research data. The present publication describes improvements to an oral glucose tolerance test (OGTT) model for pigs published in 2016. Historical data from 42 pigs were used to describe improvements in the training technique over six years. Pigs of various breeds and ages can be trained to bottle-feed glucose dissolved in water to undergo OGTT. This publication describes different tips and techniques to apply for successful training and will help researchers to minimize exclusions of pigs due to unsuccessful training. The improvements are an important contribution to the 3Rs.
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Lee, I.-Te, Yu-Hsuan Li, and Wayne Huey-Herng Sheu. "Brain-Derived Neurotrophic Factor during Oral Glucose Tolerance Test Predicts Cardiovascular Outcomes." International Journal of Molecular Sciences 21, no. 14 (July 15, 2020): 5008. http://dx.doi.org/10.3390/ijms21145008.
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We investigated if brain-derived neurotrophic factor (BDNF) accumulation after glucose intake could predict cardiovascular outcomes. We enrolled patients admitted for angiography due to angina. After their conditions stabilized, serum BDNF levels were detected at 0, 30, and 120 min during oral glucose tolerance test (OGTT). Area under the curve (AUC) of BDNF was calculated. The first occurrence of nonfatal myocardial infarction, nonfatal stroke, and all-cause mortality served as the primary composite endpoint. Of 480 enrolled patients, 428 completed the follow-up, and 36 primary endpoint events occurred during a median follow-up of 4.4 years. The area under the receiver operating characteristic curve significantly increased from 0.61 (95% confidence interval (CI): 0.52–0.73) for the Framingham risk score (FRS) alone model to 0.72 (95%CI: 0.63–0.81) for the AUC of BDNF plus FRS model (p = 0.016) for predicting the primary endpoint, but not to 0.65 (95%CI: 0.55–0.75) for the fasting BDNF plus FRS model (p = 0.160). Grouped by median AUC of BDNF of 38.0 (ng/mL) × h, the low BDNF group had a significantly higher risk of the endpoint than the high BDNF group (hazard ratio = 3.410, 95%CI: 1.520–7.653, p = 0.003). In conclusion, AUC of BDNF during OGTT could be superior to fasting BDNF for predicting a low cardiovascular risk.
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Gowda, Shashikala H., Tarigopula Swathi, and Rakshitha B. "Validation the sensitivity and specificity of diabetes in pregnancy study group of India recommended 75 g oral glucose challenge test by comparing with carpenter and couston 100 g oral glucose tolerence test." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 9 (August 26, 2021): 3544. http://dx.doi.org/10.18203/2320-1770.ijrcog20213482.
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Background: Diabetes is one of the most common non communicable diseases globally. India is considered as the world diabetes capital. Women detected with gestational diabetes mellitus (GDM) have an increased incidence of developing diabetes; especially type 2 diabetes mellitus in the later life, and future development of obesity and diabetes in the offspring. So the aim of this study is to validate the sensitivity and specificity of diabetes in pregnancy study group of India (DIPSI) recommended 75 g oral glucose challenge test (OGCT) by comparing with carpenter and couston 100 g oral glucose tolerance test (OGTT) and to note the prevalence of gestational diabetes in antenatal population attending Kempegowda Institute of Medical Sciences (KIMS).Methods: All antenatal patients reporting to our hospital at or before 24 to 28 weeks period of gestation will be recruited for the study. Patients at random will be subjected to 75g glucose load according to DIPSI criteria and one week later to carpenter and couston 100 g OGTT. Blood glucose is estimated from venous blood using glucose oxidase and peroxidase (GOD-POD) method and patients diagnosed according to respective criteria.Results: Most of the patients were in age distribution of 20–25 years. Among 100 patients in study group 28 were diagnosed as GDM by DIPSI criteria. Among 100 patients, 12 patients were detected as GDM by carpenter and couston GTT, 19 patients had impaired glucose tolerance. The incidence of GDM in the antenatal population attending KIMS hospital between gestational ages of 24–28 weeks is 12%.Conclusions: DIPSI can be used as a diagnostic test for GDM as one step simple and easy procedure especially I low resource settings like India for improved pregnancy outcome.
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Kristof, Rudolf A., Georg Neuloh, Lioba Redel, Dietrich Klingmüller, and Johannes Schramm. "Reliability of the oral glucose tolerance test in the early postoperative assessment of acromegaly remission." Journal of Neurosurgery 97, no. 6 (December 2002): 1282–86. http://dx.doi.org/10.3171/jns.2002.97.6.1282.
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Object. The suppression of growth hormone (GH) to less than 1 µg/L during the oral glucose tolerance test (OGTT) is generally considered to be the standard for the assessment of biochemical remission of GH excess following surgery for GH-secreting pituitary adenomas. In this study the authors examine the reliability of the results of the early postoperative OGTT (epOGTT) in indicating remission or persistence of active acromegaly. Methods. Data from the case files of 67 consecutive patients who underwent surgery for the first time for GH-secreting pituitary adenomas were reviewed retrospectively. Definitive remission of acromegaly was considered to be present if, without adjuvant therapy and at the most recent follow-up examination, GH was suppressed to less than 1 µg/L during the OGTT, the level of insulin-like growth factor—I (IGF-I) was within normal limits, and there was no clinical or magnetic resonance imaging evidence of persisting disease. The results of the epOGTT (obtained during the 2nd postoperative week) and the 3-month-postoperative OGTT (3mpOGTT) were compared with the patient's outcome at the most recent follow-up examination. A highly sensitive (≤ 0.3 µg/L) immunoradiometric assay for GH and a highly sensitive (≤ 32 µg/L) radioimmunoassay for IGF-I were used. Correct epOGTT findings were noted in 83.6% of the patients: correct normal results (definitive remission of acromegaly) in 55.2% and correct pathological results (persisting acromegaly) in 28.3% of the patients. The rate of false findings was 16.4%: false normal results in 1.5% and false pathological results in 14.9% of the patients. The rate of correct 3mpOGTT findings increased to 98.5%: correct normal results in 68.6% and correct pathological ones in 29.8% of the patients. A false (false pathological) 3pmOGTT result occurred in only one patient (1.5%). At the most recent follow-up examinations (median 3.6 years) all OGTT findings were correct: correct normal results in 70.1% and correct pathological results in 29.9% of the patients. An intact adenopituitary function was associated (p = 0.04) with the occurrence of false epOGTT findings. Conclusions. The high rate of false results, 16.4% for the epOGTT, declined significantly to 1.5% 3 months postoperatively and to 0% at the most recent follow-up examination. The OGTT appears to be more reliable at 3 months postoperatively. Unless there is obvious evidence of persisting disease following surgery for GH-secreting pituitary adenomas, adjuvant therapy should be delayed for 3 months postoperatively to avoid subjecting the patient to superfluous treatment.
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Landgraf, Rüdiger, Matthias Nauck, Guido Freckmann, Ulrich Müller, Lutz Heinemann, Monika Kellerer, and Dirk Müller-Wieland. "Fallstricke bei der Diabetesdiagnostik: Wird zu lax mit Laborwerten umgegangen?" Diabetologie und Stoffwechsel 13, no. 06 (December 2018): 553–63. http://dx.doi.org/10.1055/a-0762-8219.
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AbstractThe diagnosis of diabetes is associated with pre-analytical and analytical problems. Fasting glucose (FG), oral glucose tolerance test (oGTT) and HbA1c have advantages and shortcomings and have no equal diagnostic validity. oGTT is the most sensitive test, but its reproducibility is rather poor (CV ± 15 %). FG detects only 70 – 80 % of overt diabetes. FG is falsified by inappropriate blood sampling, intra-individual fluctuations and mistakes with the oGTT. HbA1c despite IFCC-standardization, but with a tolerable coefficient of variation of ± 18 % in round robin tests and use of not commutable control material is not easy to interpret. HbA1c analysis shows also interferences and is therefore of limited diagnostic value. Its threshold value of ≥ 6.5 % (≥ 48 mmol/mol Hb) is based on consensus and not on evidence. The diagnostic effort (FG and/or oGTT + HbA1c) with serious consequences is minimal invasive, reasonable and cheap. It prevents over- and underdiagnosis.
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Ionut, Viorica, Ana Valeria B. Castro, Orison O. Woolcott, Darko Stefanovski, Malini S. Iyer, Josiane L. Broussard, Miguel Burch, et al. "Hepatic portal vein denervation impairs oral glucose tolerance but not exenatide’s effect on glycemia." American Journal of Physiology-Endocrinology and Metabolism 307, no. 8 (October 15, 2014): E644—E652. http://dx.doi.org/10.1152/ajpendo.00244.2014.
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The hepatoportal area is an important glucohomeostatic metabolic sensor, sensing hypoglycemia, hyperglycemia, and hormones such as glucagon-like peptide-1 (GLP-1). We have reported previously that activation of hepatoportal sensors by intraportal infusion of glucose and GLP-1 or by subcutaneous administration of GLP-1 receptor activator exenatide and of intraportal glucose improved glycemia independent of corresponding changes in pancreatic hormones. It is not clear whether this effect is mediated via the portal vein (PV) or by direct action on the liver itself. To test whether receptors in the PV mediate exenatide's beneficial effect on glucose tolerance, we performed 1) paired oral glucose tolerance tests (OGTT) with and without exenatide and 2) intravenous glucose tolerance tests before and after PV denervation in canines. Denervation of the portal vein affected oral glucose tolerance; post-denervation (POST-DEN) OGTT glucose and insulin AUC were 50% higher than before denervation ( P = 0.01). However, portal denervation did not impair exenatide's effect to improve oral glucose tolerance (exenatide effect: 48 ± 12 mmol·l−1·min before vs. 64 ± 26 mmol·l−1·min after, P = 0.67). There were no changes in insulin sensitivity or secretion during IVGTTs. Portal vein sensing might play a role in controlling oral glucose tolerance during physiological conditions but not in pharmacological activation of GLP-1 receptors by exenatide.