Oral glucose tolerance test (OGTT)ABDULAZIZ22009.10.19 ف

8/14/2019 Oral glucose tolerance test (OGTT)ABDULAZIZ22009.10.19

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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



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.values

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



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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



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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



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.

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



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H A N K Y O UH A N K Y O U

Oral glucose tolerance test (OGTT)ABDULAZIZ22009.10.19 ف

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