DIAGNOSTIC IN CLINICAL

CHEMISTRY I
MKEB 2404
Title:
Oral glucose tolerance test

Objectives:
 To learn on how to interpret oral glucose tolerance test (OGTT)
 To understand the mechanisms involved in glucose metabolism

Introduction:
Oral glucose tolerance test (OGTT) is designed to determine how well the
body utilizes glucose after it has been absorbed into the circulation

Methods:
Subjects are in resting condition before this test was performed
1. Subject need to fasting for overnight (for at least 10 but not more than 16
hours). Water, are allowed but not for other beverage
2. A blood sample (finger – prick) was withdrawn for glucose estimation
3. A solution containing 75g glucose in 300ml of water was drunk over about
4 minutes
4. Then, further blood samples are taken after 30 minutes of glucose
ingestion (for 2 hours) and the glucose concentration are measured
5. A graph of glucose concentration vs time was plotted
6. The results was discussed

Results:
Time of blood taken Condition [Glucose] in mmol/L
09:40 1 reading (0 minutes)
st
<0.555mmol/L
10:25 2nd reading (45 minutes) 11.2mmol/L
10:50 3rd reading (70 minutes) 9.37mmol/L
11:19 4th reading (89 minutes) 4.78mmol/L
11:57 5th reading (127 minutes) 3.23mmol/L

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Interpretation of glucose tolerance test

Venous plasma glucose (mmol/L)

Fasting Two hours
Diabetes unlikely 5.5 or less 7.8 or less
Impaired glucose tolerance 5.5 – 7.8 7.8 – 11.1
diabetic 7.8 or more 11.1 or more

Discussion:
From the result that was performed, the glucose level in the subject is in a
normal condition. The slightly drop in the glucose level in the first reading
occur due to error in handling and pipetting the blood sample. After
addition of high glucose concentration we can see the sudden increase of
blood glucose concentration in the subject. This occurs in one hour after
taking the glucose solution. However, after about 1 hour, the glucose
blood level drop back and reach its normal condition again after 2 hours.
This results show that the values that was obtain from this experiment
was referred to the person in normal condition.

Fasting plasma glucose should be below 5.5mmol/l. Fasting levels

between 5.5 and 7.8mmol/l are borderline (impaired glucose tolerance),
and fasting levels repeatedly at or above 7.8mmol/l are diagnostic of
diabetes.

The 2 hour glucose level should be below 7.8mmol/l. Levels between this
and 11.1mmol/l indicates impaired glucose tolerance. Glucose levels
above 11.1mmol/l at 2 hours confirm a diagnosis of diabetes.

A standard 2 hour OGTT is sufficient to diagnose or exclude all forms of

diabetes mellitus at all but the earliest stages of development. Longer tests
have been used for a variety of other purposes, such as detecting reactive
hypoglycemia or defining subsets of hypothalamic obesity. Insulin levels
are sometimes measured to detect insulin resistance or deficiency.

The OGTT is of limited value in the diagnosis of reactive hypoglycemia,

since normal levels do not preclude the diagnosis, abnormal levels
(impaired glucose tolerance) do not prove that the patient's other
symptoms are related to a demonstrated atypical OGTT

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 There are some risks and problem that may develop when performing this
test:
• Develop a small bruise at the puncture site.
• Rarely, the capillary may become inflamed after the blood sample is
taken.

High value glucose level may be caused by:

• Gestational diabetes.
• Polycystic ovary syndrome (PCOS).
• Medications, such as corticosteroids, niacin, phenytoin (Dilantin),
some diuretics, and some medications used to treat high blood
pressure.
• Severe stress.
• Large amounts of the hormone cortisol in the blood (Cushing's
syndrome).
• Inherited diseases, such as cystic fibrosis, pheochromocytoma, or
hemochromatosis.
• Overproduction of growth hormone (acromegaly).

Low value glucose level may be caused by:

• Medications, such as medications used to treat diabetes, some blood
pressure medications (such as propranolol), and some medications for
depression (such as isocarboxazid).
• A condition that prevents the intestines from absorbing nutrients from
food, such as celiac disease.
• Decreased production of the hormones cortisol and aldosterone
(Addison's disease).
• Problems with the thyroid gland (hypothyroidism) or an underactive
pituitary gland.
• A tumor of the pancreas (insulinoma).
• Inflammation and scarring of the liver (cirrhosis).

Conclusion:
From the experiment that was performed we can conclude that in normal
and healthy person, the blood glucose level should be below 5.5 in fasting
states. Any problem that occurs in the blood glucose concentration can
indicate the impaired glucose tolerance or diabetes. The result that was
obtained from this experiment showed that the subject has a normal blood
glucose concentration and in a healthy condition.

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