Science, Technology and Medicine open access publisher.Publish, read and share novel research. The Glucose Tolerance Test as a Laboratory Tool with Clinical ImplicationsPaul Ernsberger and Richard J.
Data on the internal consistency of fasting blood glucose (FBG) and 2 hrs-oral glucose tolerance test (OGTT) are scarce despite of its importance both for research and treatment purposes. FBG and OGTT were performed on two consecutive days among the 218 (107 men and 111 women) newly diagnosed type 2 diabetes patients at BIRDEM (a diabetic hospital), Dhaka Bangladesh. Further studies are needed to investigate the observed difference in FBG measures with specific attention to BMI and the fasting state. Different diagnostic criteria have been established to reduce the risks for the development of complications among the diabetic patients [1,4].
The ADA published revised criteria for the diagnosis of diabetes that includes a FPG value, with a confirmatory test on a subsequent day [6]. All people with type 2 diabetes who were diagnosed within 4 weeks prior to the scrutiny attending FBG test at outdoor facility of Bangladesh Institute of Research on Diabetes, Endocrinology and Metabolism (BIRDEM) hospital, Dhaka, Bangladesh were requested to participate in the study during the month of November, 2003. 1st day data collection- (FBG1 and OGTT1) – Screening subjects attending BIRDEM hospital for confirmatory test were informed about the procedures of the test previously at the time of collection screening test result. 2nd day data collection- (FBG2 and OGTT2) - FBG and OGTT tests were repeated on all the subjects on the next day by ensuing the same procedure. Consistency of the diagnostic procedures FBG or OGTT for the diagnosis of diabetes mellitus appeared to be reasonably reliable on two consecutive days. Relatively stronger consistency over the repeated tests was observed among lower level of FBG values, while this was true for higher OGTT values. More investigations are needed to reduce the ambiguity of the test results by including some control subjects, preferably in the hospital and rather than fasting time to reduce the confusion, and to observe the creditability of the fasting state as assessed by interviews.
We sincerely thank the team at BIRDEM hospital for their cooperation and the subjects for their participation. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Diabetes Care 20 (1997), pp. The DECODE Study Group on behalf of the European Diabetes Epidemiology Group: Is fasting glucose sufficient to define diabetes?
Type 2 Diabetes is a result from insulin resistance, a condition which cells fail to use insulin properly. If you have a family history of diabetes, it is recommended that you undergo glucose tests every 3 months. This entry was posted in Diabetes and tagged insulin resistance, Type 2 Diabetes, type 2 diabetes symptoms.
All forms of diabetes have been treatable since insulin became available in 1921, and type 2 diabetes may be controlled with medications. 5 Factors That Determine Photography PricesProfessional photographers have different ways of charging for their services. Why Can't I Lose Weight?You ask yourself "Why can't I lose weight?" Think about it for a moment. How To Lose Stomach Fat – Eat Certain Foods And Avoid The RestIf you are trying to lose stomach fat, you must learn what type of foods you can and can not eat. Treatment Of Yeast InfectionHave you just found out that you have a yeast infection and you are wanting to get rid of it? Educational Toys For BabiesKeeping your baby entertained is a lot of fun but yet it can be challenging at the same time. When diabetes strikes during childhood, it is routinely assumed to be type 1, or juvenile-onset diabetes.
The epidemics of obesity and the low level of physical activity among young people, as well as exposure to diabetes in utero, may be major contributors to the increase in type 2 diabetes during childhood and adolescence.
Children and adolescents diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type 2 diabetes, and have insulin resistance. A patient could also go to the doctor's office for a physical exam where a venous blood draw is done and sent out to the lab for a fasting blood sugar result. As of 2010, the ADA has approved the A1c test for the diagnosis of diabetes and prediabetes. As you are filling prescriptions for people with diabetes, provide a brochure offering an A1c screening for their children. Catching diabetes early can be a huge benefit for children, because with a few minor changes such as reducing their carb intake, reading food labels, or just increasing their physical activity, parents can provide their children with a better quality of life. Nycki Etherington was shocked when she was diagnosed with gestational diabetes mellitus (GDM).
Etherington was given an oral glucose tolerance test between 24 and 28 weeks, and, like almost 10 percent of pregnant women, received a positive result.

Enduring yet another procedure during pregnancy can seem like an unnecessary inconvenience—the oral glucose tolerance test takes several hours to complete—yet it’s essential to catch and treat this condition. When she was diagnosed, Etherington fretted about everything from what foods to eat to whether her baby would make it to term (premature birth is another concern with GDM). Etherington became diligent about reading food labels, counting carbs and eschewing high-sugar foods for lower-sugar ones.
But despite the occasional elevated level, diet and exercise were enough to keep Etherington’s GDM under control during the pregnancy, as well as when she was pregnant with her second child. Tara Peel, a 43-year-old mother of two from Winnipeg, had a trickier time with her recent second pregnancy. Having to take insulin pushed Peel into the category of a high-risk pregnancy, which meant she had to abandon her natural at-home birth plan in favour of a hospital delivery and add monthly consultations with an endocrinologist to her schedule.
A version of this article appeared in our September 2015 issue with the headline, “No sweets for two”, p.
By clicking "Create Account", I confirm that I have read and understood each of the website terms of service and privacy policy and that I agree to be bound by them. Glucose tolerance test: untreated SHROB versus SHROB treated with antihyperglycemic agents and one antihypertensive agent. Further, an interview with each subject was conducted and HbA1c, bio-physical and anthropometric examinations were performed.
The observed variation for FBG and OGTT should be considered during diagnosis of diabetes or control of the condition. The most widely used diagnostic criteria for glucose intolerance was recommended by the World Health Organization (WHO) based on fasting plasma glucose (FPG) value and glucose value measured 2 hrs after a standard 75-g glucose load (OGTT) [5]. In contrast to the recommendation of ADA, World Health Organization (WHO) recommends using the OGTT in clinical practice [5].
At that time participants were asked to undertake 12 hrs fast for confirmatory test, avoid any treatment for diabetes and physical activities during this one month.
A fasting sample of venous blood was also collected for HbA1c measurement on the second day by HPLC (ion exchange high-performance liquid chromatography) using a Modular Diabetes Monitoring System (BioRad, Variant, USA) method.
However, it was observed that PD was normally distributed and that a total of 95% of the FBG and OGTT values varied respectively within approximately ± 25 % and ± 24% on a day to day basis.
We extend our thanks to Medical Statistician Geir Aamodt at the Department of Medical Statistics, University of Oslo for his assistance in analyzing the data. Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes.
Comparison of fasting And 2-hour glucose and HBA1c levels for Diagnosing diabetes: diagnostic criteria and Performance revisited. Repeatability of the oral glucose tolerance test for the diagnosis impaired glucose tolerance and diabetes? Report of a WHO Consultation, Part 1: Diagnosis and classification of Diabetes Mellitus, Geneva 1999, Worl Health Organization. Comparing methods of mesurment: why plotting difference against standard method is misleading. Day-to-day variability of fasting plasma in newly diagnosed type 2 diabetic subjects, Diabetes Care 22 (1999), pp. Comparison of the fasting and the 2-hour glucose criteria for diabetes in different Asian cohorts. Insulin and some oral medications can cause hypoglycemia (low blood sugars), which can be dangerous if severe. However, in the last two decades, type 2 diabetes (formerly known as adult-onset diabetes) has been reported among U.S. Generally, children and adolescents with type 2 diabetes have poor glycemic control (A1c = 10% - 12%). A slim 29-year-old, Etherington had no risk factors for the disease, which occurs when a woman’s pancreas isn’t able to produce the extra insulin needed to keep increased blood sugar in check during pregnancy.
Left unchecked, high blood sugar levels increase the risk of developing pre-eclampsia, which is life-threatening to both mom and baby. She knew she needed to adopt a healthy eating plan and incorporate more exercise into her routine to help manage her glucose levels. Through trial and error, she found that potatoes, her favourite food, spiked her glucose levels so much that she had to cut them out completely, along with her beloved pasta and baguettes. Having many risk factors for GDM (she’s over 35, had GDM in her first pregnancy and has a family history of diabetes), Peel was expecting the diagnosis, even though she had adopted a diabetes-friendly diet and boosted her exercise level early on. The disease disappeared within weeks after the birth (as it does for almost all women with GDM), but she and her children are at an increased risk of developing type 2 diabetes later in life; one in five women who had GDM will be diagnosed with type 2 diabetes within nine years of giving birth, and their children are six times more likely to develop the disease than their peers. A 17-gauge Luer-lock venflon was inserted in to both anticubital fossa and sample was taken for HbA1c.

Statistical comparisons among sex, BMI, SBP and DBP were made by one sample t- test for continuous variables and chi-square tests for group comparisons.
The inconsistency of the test results was largely influenced by female subjects following FBG procedure.
HbA1c appeared to have improved associations with FBG measures contrasting against OGTT values.
The upper limit of blood glucose measurement by HemoCue Blood-glucose analyzer and sample size may also be a concern for further investigation.
Since GDM has no real symptoms (common complaints of people with diabetes, such as tiredness and frequent urination, are often normal parts of pregnancy), she had no warning signs. As well, women with GDM may give birth to very large babies, which can get stuck in the birth canal and require intervention, such as a C-section.
In fact, one Ontario-based study by the Institute for Clinical Evaluative Sciences and Mount Sinai Hospital found the rate of GDM and pre-GDM (diabetes that existed prior to the pregnancy) doubled from 1996 to 2010, largely due to lifestyle changes. To ease the transition, she attended free diabetes courses at Women’s College Hospital in Toronto, where she learned about nutrition, obtained a glucose meter, and was taught how to prick her finger and interpret the results. Because Peel’s blood sugar rose while she slept, no matter how perfect it was during the day, she had to give herself insulin injections every night before bed. As a result, both Etherington and Peel are maintaining their healthy lifestyles, and they both schedule annual checkups to ensure they keep the diabetes at bay. Moreover, the DECODE study found that almost 30% of all patients with diabetes (based on fasting or 2hrs - PG following OGTT or both) would remain undetected [7]. At the end of 2hrs blood glucose test, all subjects were interviewed to collect information regarding socio-economic, family history, treatment history and smoking habit etc.
Anthropometrical data and blood pressure were measured in the same examination room to avoid any influence of physical activity between 2 hrs time of glucose drink and OGTT2.
Moreover, both FBG and OGTT values appeared to have no significant deviation from normality as assessed by the PD. Either setting will likely have implications in the epidemiology, treatment and control of the state of diabetes. Pancreas transplants have been tried with limited success in type 1 DM; gastric bypass surgery has been successful in many with morbid obesity and type 2 DM. The keys were eating well, resisting temptation (parties were tough) and exercising frequently (she favoured going for brisk walks and dancing).
Please check your email, click the link to verify your address, and then submit your comment. SHR were fed a supplementary sweet drink to induce dietary obesity in these genetically lean rats.
This low agreement may raise concern for identification and treatment of people with diabetes. Moreover, the increased variability was also stratified by hypertension, which may raise attention for diagnosis of hypertensive subjects. In fact, if women with GDM are properly monitored and work to keep their blood sugar levels in check, most go on to have healthy pregnancies. Peel even found ways to work well-loved foods into her diet: When craving a hamburger, she ate it open-faced and opted for a salad instead of fries. If you can't find this email, access your profile editor to re-send the confirmation email. It was also recommended by ADA that the internal stability of the diagnostic procedures should be carefully considered when monitoring glycemic control for people with diabetes [10,13]. Liner regression analysis was carried out to describe the relation between FBG, OGTT and HbA1c with PDs and averaged values of them. Therefore, elevated variability of the test results among women and hypertensive subjects by FBG procedure deserves attention for future studies with a focus on obese status.
This may have been true for the newly diagnosed cases as was observed in other studies [18]. Data on the internal consistency of these two procedures is scarce especially from ethnic groups representing the highest increase of incidence in type 2 diabetes. Scattered diagrams are also presented to indicate the correlation and inter-relationship of those values. Therefore the purpose of the study was to assess the day to day variability of FBG and OGTT in people with newly diagnosed type 2 diabetes in Bangladesh. In addition, both the diagnostic procedures were examined against glycosylated hemoglobin A1c in order to observe the strength of FBG and OGTT procedures.

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