GLUCOSE TOLERANCE TEST (GTT)
Description
Fasting plasma glucose (measured before GTT) :
< 110 mg/dl Normal
110 – 125 mg/dl Borderline
>125 mg/dl Diabetic
A 1 hour GTT below 180 mg/dl is considered normal
For a 2 hr GTT with 75 g intake,
Glucose level <140 mg/dl is normal
140 -200 mg/dl – impaired glucose tolerance
>200 mg/dl at 2 hrs - Diabetic
Clinical significance
- Glucose Tolerance test measures how well the body cells are able to absorb glucose, or sugar ,after you ingest a given amount of sugar. 75 gm of oral dose is the recommendation by WHO to be used in adults . The dose shall be drunk in 5 minutes. This protocol challenges the person’s body to process the glucose
For Gestational Diabetes (using one step or 2 step approach)
One step approach
- After a fasting glucose level is measured, a woman is given 75 gm dose of glucose to drink and her glucose levels are measured at 1 hour and 2 hours after the dose. Only one of the values needs to be above a cut off value for diagnosis.
2 Step approach
- At 24-28 weeks - 1 hr venous glucose measurement following 50 gm oral glucose solution (GLUCOSE CHALLENGE TEST), followed by a 3 hr 100 gm Oral glucose tolerance test , if positive.
- Diagnosis of gestational diabetes mellitus is based on 2 abnormal values on the 3 hour OGTT(measured at 1 hr, 2 hr and 3 hr)
- Post 1 hr 50 gm GCT : 140 mg/dl
3 hrs OGTT
- Fasting - 95 mg/dl
- 1 hours : 180 mg/dl
- 2 hours : 155 mg/dl
- 3 hours : 140 mg/dl
When to get tested
- When a person is aged 45 or older
- When a person of any age has risk factors(Overweight, physically inactive, PCOS , High BP , Low HDL level and high Triglyceride level, h/o cardio vascular disease)
- When there is s/s of high Glucose ( Increased Thirst, frequent urination , fatigue , blurred vision , slow healing wounds or infections )
Elevated level
- Acute stress
- Diabetes
- Acromegaly
- Chronic kidney disease
- Hyperthyroidism
- Pancreatic cancer
Decreased level
- Adrenal insufficiency
- Liver disease
- Hypothyroidism
- Renal failure
- Insulinoma
Profile
Diabetes
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