The Glucose Tolerance Test (GTT) is the most sensitive test for detecting borderline diabetes

mellitus.. It is indicated by the nature of blood glucose curve following the administration of
glucose. Thus “glucose tolerance test” is a valuable diagnostic aid in the diagnosis of diabetes
mellitus, insulin resistance, impaired beta-cell functionnand sometimes reactive hypoglycemia
and acromegaly.

Oral Glucose Tolerance Test (OGTT)

Principle
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.

Indications and Contraindications for OGTT

Indications

The OGTT is indicated in following conditions :

 Patients having symptoms suggestive of diabetes mellitus, but fasting blood sugar value
is inconclusive (between 100-126 mg/dl).
 During pregnancy, excessive weight gaining is noticed, with a past history of big baby
(more than 4 kg) or a past history of miscarriage.
 To rule out benign renal glucosuria.

Contraindications

 It is indicated only for the initial diagnosis.

 The test should not be done in acutely ill patients.

Procedure for OGTT

Patient Preparation

1. The patient should be on balanced diet, containing normal daily requirement of

carbohydrates, at least 2-3 days prior to the test.
2. Patients should avoid drugs likely to influence the blood glucose levels, at least 2 days
prior to the test.
3. Patient should report to the laboratory after fasting for 12-16 hours. He/She can drink
water.
4. Patients should be in a position to wait at the laboratory for at least 2-3 hours, since 3 to 5
or more blood samples are collected at the interval of 30 or 60 min as requested by the
physician.
Conduction of OGTT

1. A fasting sample of venous blood is collected in a fluoride vial.

2. The bladder is emptied completely and urine is collected for qualitative test for glucose
and ketone bodies.
3. The individual is given 75 grams of glucose dissolved in water (about 250 ml). Addition
of lemon juice lessens the risk of patient vomiting.
4. Note the time of oral glucose administration.
5. A total of five specimens of venous blood and urine are collected every 1/2 hour (30
minutes) after the oral glucose administration.
6. Glucose content of all five samples of blood are estimated in laboratory. Corresponding
urine samples are tested qualitatively for the presence of glucose and ketone bodies.
7. A curve is plotted by plotting time on X-axis and plasma glucose level on Y-axis, which
is called Glucose Tolerance Curve (GTC).

Normal Values and Interpretation of OGTT