Glucose Tolerance Test

Oral & Intravenous Glucose
Tolerance Test
Supervised by
Khalid Saied Osman
Prepared by
Rahma Abdullah Alrando
Contents
• Introduction
• Principle of GTT
• Method & Types
• The different types of curves in Glucose Tolerance
Test
• Oral GTT
• Intravenous GTT
• Result
• Conclusion
Introduction
 The Glucose Tolerance Test (GTT) is the most
sensitive test for detecting borderline diabetes
mellitus, tolerance means ability of the body to
utilize glucose in the circulation, It is indicated by
the nature of blood glucose curve following the
administration of glucose.
 GTT is of two types depending upon the route of
glucose administration :↓
1. Oral Glucose Tolerance Test (OGTT).
2. Intravenous Glucose Tolerance Test (IVGTT).
Principle of GTT
 Following a standard oral dose

of glucose, plasma and urine
glucose levels are monitored
at regular intervals, in order to
measure tolerance under
defined conditions.
Method & Types
 Procedure of Glucose Tolerance Test :↓
1. Patient should take normal meal or carbohydrate diet 3 or
4 days before the test.
2. Test is usually done after a overnight fasting. (It may be
done 5 hours after fasting).
3. Fasting blood and urine samples are collected.
4. Patient should take 75 grams of glucose dissolved in 200
ml of distilled water.
5. Blood is taken every 30 minutes up to 2½ hour (5
samples are taken).
Method & Types
6. Urine is collected after taking glucose at the end

of 1 hour and at the end of 2 hours (3 samples).
7. Blood sugar is estimated by blood sample and
urine is examined in the presence of sugar;
there is a graphical representation where in time
(in hours) is along base line and blood glucose
or sugar (mg/dl) along vertical line.
Types of curves
A. Normal Response.
 Initial rise of blood sugar is normal and it never crosses renal thresh-hold.
 It returns to normal within 1 hours usually, and almost always within 2 hours.
Types of curves
B. Abnormal Response :↓
I. Diminished glucose tolerance
 In this condition blood sugar is increased more than in
normal patient, fasting blood sugar may be high and
return to normal level is delayed, Urine shows
glycosuria in most sample.
 Two types of curves :
i. Curve for true diabetes.
ii. Curve for potential diabetes.
Types of curves
II. Increased glucose tolerance

.
 fasting blood sugar is normal. Increase of
blood sugar is not very much, always below
renal threshold, and comes back to normal
within half an hour. This curve is called flat
type curve.
Types of curves
III. Lag curve
 Some apparently normal people are found to have log

tolerance curve in which return of blood sugar is
normal but with certain exaggeration of blood sugar
level, The return to normal value is sharp and rapid.
 So peak rise is always above renal threshold and sugar

is absent in fasting sample.
Types of curves
IV. Decreased renal threshold
 In some patient, blood sugar level is not very

high. But sugar is present in urine. Blood sugar
level does not exceed renal threshold but still
there is glycosuria. So renal threshold is
decreased. This is called renal glycosuria and it
is accidently detected.
Types of curves
V. Increased renal threshold
 Blood sugar is always high. Fasting sugar is also
high.
 It is increased ½ to 1 hour after taking glucose
although blood sugar level is above 200 mg/dl. But
there is no glycosuria.
 Urine examination of this group of patients does not
give true picture of diabetes and this is a true
diabetic curve without glycosuria.
Oral GTT
 Is currently the gold standard for the

diagnosis of diabetes, it is extensively
used as sensitive indicator of
gestational diabetes, the OGTT
provide an indication of the relative
roles of insulin secretion and insulin
resistance in the progression of
glucose intolerance.
Oral GTT
Intravenous GTT
 These test is used with patient who are unable

to absorb an oral dose of glucose.
ex: malabsorbtion syndrome.
 It is carried out by giving 25g of glucose
dissolved in 100ml intravenous injection
within 5 minutes.
 The values for the IVGTT differ slightly from
those of oral GTT because IV glucose is
absorbed faster.
Intravenous GTT
 The Significance of the IV Glucose Tolerance Blood Test Result :↓
 An initial value for the IV Glucose Tolerance Blood Test is taken when
fasting. The levels are then measured after an interval of 5, 30, 60, and
120 minutes respectively.
 The interpretation of IVGTT :↓
 In normal individuals, blood glucose level return to normal within 60
minutes.
 In diabetes mellitus, decline is below.
 The initial values are attained in 2h.
Intravenous GTT
Intravenous glucose tolerance test (IVGTT)
Result
Conclusion
Intravenous GTT Oral GTT
We inject 25g glucose intravenously over a period of 4 The diabetic patient typically starts from high fasting
minutes, we then measure the blood glucose in intervals . glucose, such as values ≥126mg/dL, and increase to very
.high level
IVGTT is more sensitive than the OGTT because the The blood glucose is not back to normal within 2h,but
glucose samples doesn't have to go through the digestive .always ≥200mg/dL
. system
allows for individuals who cannot eat or tolerate glucose
These test pattern is the clinical who criterion of diabetes.
.to measure their glucose tolerance
The IV Glucose Tolerance Blood Test should not be The recommended preparation for and administration of
performed if the resting blood sugar is greater than 200 the OGTT are important to ensure that test result are not
mg/dL. effected.
Always keep in good health
Reference
• https://laboratoryinfo.com/glucose-tolerance-test-gtt-principle-procedure-indications-interpr
etation/
• http://www.biologydiscussion.com/biochemistry/carbohydrate-metabolism/glucose-toleranc
e-test-types-utility-and-procedure/43370
• https://www.dovemed.com/common-procedures/procedures-laboratory/iv-glucose-toleranc
e-blood-test/
• http://www.zuniv.net/physiology/book/chapter27.html
• https://www.slideshare.net/pgiprakash/glucose-tolerance-test-indication-and-procedure

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Oral & Intravenous Glucose

 Following a standard oral dose

6. Urine is collected after taking glucose at the end

II. Increased glucose tolerance

III. Lag curve

 Some apparently normal people are found to have log

 So peak rise is always above renal threshold and sugar

IV. Decreased renal threshold

 In some patient, blood sugar level is not very

 Is currently the gold standard for the

 These test is used with patient who are unable

You might also like

Glucose Tolerance Test

Uploaded by

Copyright:

Available Formats

Glucose Tolerance Test

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

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Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Glucose Tolerance Test

Uploaded by

Copyright:

Available Formats

Oral & Intravenous Glucose

 Following a standard oral dose

6. Urine is collected after taking glucose at the end

II. Increased glucose tolerance

III. Lag curve

 Some apparently normal people are found to have log

 So peak rise is always above renal thresh­old and sugar

IV. Decreased renal threshold

 In some patient, blood sugar level is not very

 Is currently the gold standard for the

 These test is used with patient who are unable

You might also like

 So peak rise is always above renal threshold and sugar