Oral glucose tolerance test (OGTT)ABDULAZIZ22009.10.19 ف
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Transcript of Oral glucose tolerance test (OGTT)ABDULAZIZ22009.10.19 ف
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ral Glucoseral Glucoseolerance Testolerance Test Byybdulaziz Massoud Alfaydibdulaziz Massoud Alfaydi
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ral Glucoseral Glucose( )olerance Test OGTT( )olerance Test OGTTDefinition.Procedure.
Curves.Different Types Explain.
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DEFINITIONDEFINITION
The Term Diabetes Mellitus Describes SeveralDiseases Of Abnormal Carbohydrate Metabolism
That Are Characterized By Hyperglycemia.It Is Associated With A Relative Or Absolute
Impairment In Insulin Secretion, Along WithVarying Degrees Of Peripheral Resistance To
The Action Of Insulin.
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CONTINUEDCONTINUED
.The Glucose Tolerance Test (GTT) Consists OfDrinking (75 To 100 )Grams Of Glucose Solution .
.Measuring The Blood Glucose Values Every HourToGet A Curve ..A 2 Hour GTT Is Used To Diagnosis Diabetes , But A
6 Hour Test Might Also Diagnosis Diabetes PlusHypoglycemia.
.Symptoms Of Hypoglycemia Occur After The 5 ThHour.
.In Healthy Individual The Insulin Response To A
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TerminologyTerminology
Normoglycemia - Fasting Blood Glucose 75-100mg/dL.
Impaired GlucoseTolerance: 110-126mg/dL.
Hyperglycemia : >126mg/dL.
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10/18/09 6
ABNORMALABNORMALHYPERGLYCEMIA.
HYPOGLYCEMIA.
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Factors affecting GTTFactors affecting GTT
Concerned with the blood glucose regulation:
1.Metabolic-diet-thiamine.
-starvation.
-excretion.
-liver diseases, infection.
2.Hormones-insulin:
-antagonists.epinephrine,glucagon,glucocorticoids,GH,THYROXIN.
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ProcedureProcedure
This Is Timed Test For Glucose Tolerance HourPlasma . A-2 Glucose Test Is Done AfterGlucose Load To Detect Diabetic Individuals OtherThan Pregnant Women .
The 3- Hour Test Is Done For Pregnant WomenThe 4- Hour Test Evaluates Possible Hypoglycemia.
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ContinuedContinued1- Have Patient Eat A Diet With >150 g OfCarbohydrates For 3 Days Before The Test.
Administer 1.75g/Kg Body Weight Oral GlucoseSay Dissolved In 250 ml Of Water
Allow Him To Drink The Glucose Solution Over APeriod Of5 Minute Time
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DRUGSDRUGS
2-Ensure That The Following Drugs AreDiscontinued 3 Days Before The Test Because
They May Influence Test Results:
A) Hormones , Oral Contraceptives , Steroids.B)salicylates, Anti Inflammatory Drugs.C)diuretic Agents.D) Hypoglycemic Agents..E) Antihypertensive Drugs And Other Drugs As
Advised By The Diabetologist.
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CONTINUEDCONTINUED3-A 5ml Sample Of Venous Blood Is Drawn. The
Patient Should Fast 12 To 16 Hours Before Testing .4-blood Samples Are Obtained 30 Minutes , 1 Hr,
2hrs, 3hrs After Glucose Ingestion.5- Specimens Taken 4 Hrs After Ingestion Are
Significant For Detecting Hypoglycemia .
6-Tolerance teste can also be performed for Pentose,Lactose ,Galactose And D- Xylose.
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PossiblePossibleInterpretationInterpretation
a) Persistent fasting hyperglycemia >140mg/dl Or>7.8mmol/L.
b) Persistent fasting normal plasma glucose .c) Patient with overt diabetes mellitus.d) Persistent 2-hour plasma glucose >200mg/dl Or
>11.1mmol/L.
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Interfering factorsInterfering factors
1- Smoking Increases Glucose Levels.2-altered Diets (Weight Reduction) Before Testing
Can Diminish Carbohydrate Tolerance And Suggest,False Diabetes.
Glucose Levels Normally Tend To Increase WithAging.
3-prolonged Oral Contraceptive Use CausesSignificantly Higher Glucose Levels In The SecondHour Or In Later Blood Specimens.
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continuedcontinued4-Infections disease illnesses and operativeprocedures affect glucose tolerance..5- Certain drugsa) Corticosteroids.b) Estrogens.
c) Heparin.d) Nicotinic acid .e) Phenothiazines.f) Lithium .
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CONTINUEDCONTINUED
STATE NORMAL IMPAIRED DIABETES
Fasting 70-110 110-126 (IFG) >126
2 Hr(mini GTT) 140 140-200(IGT) >200
di t S l
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curve according to SealeHarris
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose
[mg/dl]
80 90 105 90 80 80 80 80
1b N l M i
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1b. Normal Maximumcurve
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose
[mg/dl]
120 135 160 130 110 100 110 105
di b t
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diabetes
Time [hours]
0 0.5 1 2 3 4
5
6Blood glucose[mg/dl] 115 145 180 160 120
130 130 130
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.diabetes
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose[mg/dl] 200 235 265 280 300 295 280 270
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hypoglycemia
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose[mg/dl] 100 160 220 160 85 60 50 85
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.values
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose[mg/dl] 60 80 100 60 60 60 60 55
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6. Pre-hypoglycemia
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose [mg/dl] 90 115 140 100 85 80 70 75
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7. Mild hypoglycemia
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose [mg/dl] 80 120 80 60 80 75 80 80
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.II
Time [hours] 00.5 1 2 3 4 5 67
Blood glucose [mg/dl] 100 170 110 130 170 125 100100
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10. Flat curve
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose [mg/dl] 90 90 90 100 90 100 80 90
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.
Time [hours] 0 0.5 1 2 3 4 5 6
Blood glucose[mg/dl] 95 110 120 105 100 60 40 60
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H A N K Y O UH A N K Y O U