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After oral administration of large amounts of glucose in healthy subjects, insulin is released immediately and reaches a maximum after about 30-60 minutes. When we have enough insulin to metabolize glucose at the beginning of the test, glucose levels return to normal in about 3 hours.
Insufficient secretion of insulin or peripheral insulin resistance will lead to a significant increase in blood glucose.
When determining basal (fasting) or postprandial blood glucose, the test can confirm or deny the diagnostics of diabetes.
Test contraindications
Adults: 75 g of glucose dissolved in cold water should be drunk for 5 minutes.
Children: The amount of glucose depends on the patient's weight: 1,75 g / kg body weight - maximum 75 g.
A blood sample will be taken 120 minutes after the glucose administration.
In certain clinical situations, at the request of the physician, several samples may be taken: 30, 60, 90, 120, 180 minutes.
Side effects: Some people may have nausea or vagal symptoms during the test.
Interpretation of basal blood glucose values and glucose tolerance test is performed according to ADA (American Diabetes Association) criteria:
| Normoglycemia | Conditions associated with an increased risk of diabetes | Diabetes mellitus | |
| Basal glucose in the blood | <100 mg / dL (<5,6 mmol / L) | 100-126 mg/dL (5.6-6.9 mmol/L) | 126 mg / dl |
| Blood glucose, 75 hours after ingestion of 2 g of glucose | <140 mg / dl | 140-200 mg / dL (7.8-11.1 mmol / L) (for intolerant glucose) | ≥200 mg / dL (≥11.1 mmol / L) |
At least two abnormal glucose tolerance tests are required to diagnose diabetes.
The glucose tolerance test is useful not only for diagnosing diabetes but also for identifying patients with impaired glucose tolerance (IGT).
People with IFG (increased glucose tolerance) as well as individuals with IGT are part of an intermediate group who, although they do not meet the diagnostic criteria for diabetes, have too high a glucose level to be considered normal. These people were previously considered to have prediabetes, but according to the new ADA (2010) recommendations, IFG and IGT should not be considered as independent clinical units, but as high-risk categories in the development of diabetes and cardiovascular disease. IFG and IGT are associated with obesity (especially in the abdomen), high blood pressure, and dyslipidemia (high triglycerides and low HDL-cholesterol). Increased physical activity, weight loss, and the intake of certain pharmacological agents prevent or slow down the development of diabetes in people with glucose intolerance.
Other clinical conditions related to glucose tolerance:
Diagnostic limitations
The test has limited relevance in the diagnostics of diabetes in children and is rarely used for this purpose.
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