Glucose Tolerance Test (OGTT/GTT) - Indications, Preparation, Interpretation Of Results

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Glucose tolerance test is used to evaluate the ability to regulate glucose metabolism and is indicated when the random or fasting blood glucose testing alone is not sufficient to establish or rule out the diagnosis of diabetes.
Plasma glucose levels reflect a combination of carbohydrate uptake from the gastrointestinal tract, glucose output from the liver, and glucose uptake from the peripheral tissues. Glucose tolerance test is indicated when the serum glucose level alone is not sufficient to establish or exclude the diagnosis of diabetes. In addition, it is used to screen for gestational diabetes at 24 to 28 weeks of gestation in all pregnant women with no history of diabetes, to screen for diabetes mellitus at 6 to 12 weeks post-partum in women with a history of gestational diabetes, and to screen for impaired glucose tolerance, which is associated with an increased risk of diabetes mellitus.
For 3 days preceding the test, person should have a diet containing approximately 150 carbohydrates daily. Before the test, person should fast overnight for a minimum of 8 hours and a maximum of 16 hours. The test is usually performed in the morning and should be seated throughout the test. Baseline fasting glucose is measured before the test. The person is given a 75g oral glucose load. Very rarely, it may e given intravenously. In the standard test, plasma glucose level is measured after 2 hours of glucose load. However, in gestational diabetes, additional measurement is taken after one hour of the glucose load.
Cut of values for type 2 diabetes include the following. Blood glucose level less than 140 mg per deciliter is considered normal. Blood glucose level between 140 to 199 mg per deciliter is considered prediabetes. And blood glucose level more than 200 mg per deciliter is considered to be having diabetes. A diagnosis of gestational diabetes can be made if one of the following criteria are made. Blood glucose level equal to or more than 180 mg per deciliter after one hour following the oral glucose load, or blood glucose level equal to or more than 153 mg per deciliter after 2 hours following the oral glucose load.

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