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  • Title: Rethinking the accuracy of 75g glucose used in the oral glucose tolerance test in the diagnosis and management of diabetes.
    Author: Kim SH, Park TS, Jin HY.
    Journal: Prim Care Diabetes; 2017 Dec; 11(6):555-560. PubMed ID: 29150012.
    Abstract:
    AIMS: We investigated the specificity of the 75g oral glucose tolerance test (OGTT) and the clinical usefulness of the 2h post loading glucose (2h PLG) value in the clinical care of diabetes patients. METHODS: The 75g OGTT data of 1755 subjects were analyzed. The relationships and degrees of consistency among 2h PLG, fasting plasma glucose (FPG), and HbA1c values were assessed. We also investigated the degree of contribution of 2h PLG in the prescription of glucose-lowering agents and in the pitfall group for use of 75g OGTT. RESULTS: Among 595 subjects with normal FPG, only 329 (55.3%) showed normal 2h PLG level, and 66 (11.1%) patients could be considered as having diabetes. Among 454 diabetes patients (based on FPG and HbA1c), 409(90.1%) showed 2h PLG values in the range of diabetes, 45 (9.9%) subjects did not exhibit diabetes. Pitfall group who used 75g OGTT for diagnosis diabetes (lower 2h PLG value compared to fasting and upper 2h PLG value compared to fasting) showed differences in body weight and height. CONCLUSIONS: Based on OGTT results, around 10% patients cannot be diagnosed with diabetes based solely on the 2h PLG value. Further studies on differences in glucose loading according to body weight, individual life pattern, and calorie requirement are needed for improvement of the specificity of the OGTT in the clinical management of diabetes.
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