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2 Hour Glucose Tolerance Test Pregnancy Normal Range

Two-hour 75-g Oral Glucose Tolerance Test Early In Pregnancy Detects Most Cases Of Gestational Diabetes

Two-hour 75-g Oral Glucose Tolerance Test Early In Pregnancy Detects Most Cases Of Gestational Diabetes

We congratulate Schmidt et al. (1) for their excellent work on gestational diabetes mellitus (GDM), published in Diabetes Care. We would like to make several comments. We believe that testing for GDM early in pregnancy would help to detect cases and has the potential to improve pregnancy outcomes. Also, World Health Organization criteria for the diagnosis of GDM received further endorsement at the Fourth International Workshop-Conference on Gestational Diabetes Mellitus in 1977 (2); therefore, 2-h 75-g glucose may be a better diagnostic test than fasting glucose alone (3) or the currently recommended American Diabetes Association criteria for GDM. We tested 564 patients attending the antenatal clinic of Ibra Regional Referral Hospital of Oman for glucose intolerance by glucose tolerance test using 75 g anhydrous glucose. Oral glucose tolerance tests (OGTTs) were performed at booking. If the results were normal, the test was repeated two or three times at 2-month intervals, the last being at the 7th month of pregnancy. We found that 21.3% of pregnant women had abnormal glucose tolerance in Oman. A small proportion (1.1%) had high fasting values (>6 mmol/l in venous plasma), whereas many (20.2%) had high post-glucose values (>7.8 venous plasma). Over 88% of the patients with GDM were diagnosed before the 7th month of pregnancy. Hence, a large proportion of cases were detected by a test early in pregnancy rather than the usual recommended time of screening for GDM at 7 months of pregnancy. In our study, 10% of women required a second test, and 2.5% were diagnosed only at the third test. Of the children born to the GDM subjects, 10% had a complication or abnormality. Birth weight of the children in the GDM group was 3.13 kg (SD 0.54) compared with 2.90 kg (0.44) in the nond Continue reading >>

Influence Of Lower Cutoff Values For 100-g Oral Glucose Tolerance Test And Glycemic Profile For Identification Of Pregnant Women At Excessive Fetal Growth Risk.

Influence Of Lower Cutoff Values For 100-g Oral Glucose Tolerance Test And Glycemic Profile For Identification Of Pregnant Women At Excessive Fetal Growth Risk.

Department of Gynecology, Obstetrics and Mastology, Botucatu Medical School, So Paulo State University, So Paulo, Brazil. To evaluate data from patients with normal oral glucose tolerance test (OGTT) results and a normal or impaired glycemic profile (GP) to determine whether lower cutoff values for the OGTT and GP (alone or combined) could identify pregnant women at risk for excessive fetal growth. We classified 701 pregnant women with positive screening for gestational diabetes mellitus (GDM) into 2 categories -- (1) normal 100-g OGTT and normal GP and (2) normal 100-g OGTT and impaired GP-to evaluate the influence of lower cutoff points in a 100-g OGTT and GP (alone or in combination) for identification of pregnant women at excessive fetal growth risk. The OGTT is considered impaired if 2 or more values are above the normal range, and the GP is impaired if the fasting glucose level or at least 1 postprandial glucose value is above the normal range. To establish the criteria for the OGTT (for fasting and 1, 2, and 3 hours after an oral glucose load, respectively), we considered the mean (75 mg/dL, 120 mg/dL, 113 mg/dL, and 97 mg/dL), mean plus 1 SD (85 mg/dL, 151 mg/dL, 133 mg/dL, and 118 mg/dL), and mean plus 2 SD (95 mg/dL, 182 mg/dL, 153 mg/dL, and 139 mg/dL); and for the GP, we considered the mean and mean plus 1 SD (78 mg/dL and 92 mg/dL for fasting glucose levels and 90 mg/dL and 130 mg/dL for 1- or 2-hour postprandial glucose levels, respectively). Subsequently, the women were reclassified according to the new cutoff points for both tests (OGTT and GP). Consideration of values, in isolation or combination, yielded 6 new diagnostic criteria. Excessive fetal growth was the response variable for analysis of the new cutoff points. Odds ratios and their respective c Continue reading >>

Glucose Tolerance Testing

Glucose Tolerance Testing

Glucose tolerance testing (GTT) is used to evaluate the ability to regulate glucose metabolism and is indicated when random/fasting blood glucose testing alone is insufficient in establishing or ruling out the diagnosis of diabetes mellitus. The reference range of serum or plasma glucose is less than 140 mg/dL at 2 hours after a 75-g glucose load. Continue reading >>

2-hour Glucose Tolerance Test (plasma) During Pregnancy

2-hour Glucose Tolerance Test (plasma) During Pregnancy

What is the 2-Hour Glucose Tolerance Test? In some cases, the 2-hour glucose tolerance test may be used in place of the 1-hour glucose tolerance test for pregnant women. Women visit the lab after fasting the night before and give a sample of blood. Then, a 75 gram glucose solution is consumed orally. One hour and two hours after consumption blood draws are taken to measure blood glucose. If levels are higher than normal at any stage of the test, additional testing may be ordered to rule out, or definitively diagnose, gestational diabetes. The test requires at least three days of normal food consumption and activity before fasting. Smoking is not allowed during the test as results may be affected. Normal Value Range Fasting Values: 92 mg/dL or 5.1 mmol/L 1-Hour Values: 180 mg/dL or 10 mmol/L 2-Hour Values: 153 mg/dL or 8.5 mmol/L * Values are not affected by pregnancy Continue reading >>

Glucose Screening Tests During Pregnancy

Glucose Screening Tests During Pregnancy

TWO-STEP TESTING During the first step, you will have a glucose screening test: You DO NOT need to prepare or change your diet in any way. You will be asked to drink a liquid that contains glucose. Your blood will be drawn 1 hour after you drink the glucose solution to check your blood glucose level. If your blood glucose from the first step is too high, you will need to come back for a 3-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose, 100 grams (g) . You will have blood drawn before you drink the liquid, and again 3 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 3 hours for this test. ONE-STEP TESTING You need to go to the lab one time for a 2-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose (75 g). You will have blood drawn before you drink the liquid, and again 2 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 2 hours for this test. Continue reading >>

Blood Tests For Diabetes: Oral Glucose Tolerance Test

Blood Tests For Diabetes: Oral Glucose Tolerance Test

Also known as: OGTT; 2-hour glucose tolerance test. What is it? A test that measures blood glucose levels before and 2 hours after you drink an oral dose of glucose solution (75 to 100 grams of an extremely sweet drink), which should cause glucose levels to rise in the first hour, then fall back to normal within two hours as the body produces insulin to normalize glucose levels. Test results show how well your body is able to process glucose. Why is this test performed? To confirm a diagnosis of diabetes or gestational diabetes (and to diagnose other metabolic diseases). Because the OGTT is a more sensitive test than the fasting plasma glucose test, and involves multiple blood draws to monitor insulin production, it can often detect cases of diabetes that may be missed by the fasting test. How is the oral glucose tolerance test performed? The OGTT is typically performed in the morning, after you’ve fasted for at least eight hours. Your blood will be drawn to measure your fasting blood sugar level. You will then be given the sugary solution to drink, and your blood sugar levels will be tested periodically over the next two hours. How frequently should this test be performed? Once, in select individuals, for diagnosis of diabetes. A second retest may be appropriate in some patients, particularly pregnant women being tested for gestational diabetes. Additional laboratory tests may be required for an accurate diagnosis. What is the “normal” range for results? While laboratory test methods and measurements can vary for this test, normal OGTT results in those who are not pregnant are as follows: Fasting: 60 mg/dl to 99 mg/dl (3.3 mmol/l to 5.5 mmol/l) 1 hour: Less than 200 mg/dl (11.1 mmol/l) 2 hours: Less than 140 mg/dl (7.8 mmol/l) Factors such as age, weight, and rac Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Key Messages Pregestational Diabetes All women with pre-existing type 1 or type 2 diabetes should receive preconception care to optimize glycemic control, assess complications, review medications and begin folate supplementation. Care by an interdisciplinary diabetes healthcare team composed of diabetes nurse educators, dietitians, obstetricians and diabetologists, both prior to conception and during pregnancy, has been shown to minimize maternal and fetal risks in women with pre-existing type 1 or type 2 diabetes. Gestational Diabetes Mellitus The diagnostic criteria for gestational diabetes mellitus (GDM) remain controversial; however, the committee has chosen a preferred approach and an alternate approach. The preferred approach is to begin with a 50 g glucose challenge test and, if appropriate, proceed with a 75 g oral glucose tolerance test, making the diagnosis of GDM if ≥1 value is abnormal (fasting ≥5.3 mmol/L, 1 hour ≥10.6 mmol/L, 2 hours ≥9.0 mmol/L). The alternate approach is a 1-step approach of a 75 g oral glucose tolerance test, making the diagnosis of GDM if ≥1 value is abnormal (fasting ≥5.1 mmol/L, 1 hour ≥10.0 mmol/L, 2 hours ≥8.5 mmol/L). Untreated GDM leads to increased maternal and perinatal morbidity, while treatment is associated with outcomes similar to control populations. Introduction This chapter discusses pregnancy in both pre-existing diabetes (pregestational diabetes) as well as gestational diabetes (GDM; diabetes diagnosed in pregnancy). Some of the management principles are common to both types of diabetes. These recommendations have been created in collaboration with the Society of Obstetricians and Gynaecologists of Canada (SOGC). Glucose Levels in Pregnancy Elevated glucose levels have adverse effects on the fetus throu Continue reading >>

Glucose Tolerance Test

Glucose Tolerance Test

The glucose tolerance test is a medical test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood.[1] The test is usually used to test for diabetes, insulin resistance, impaired beta cell function,[2] and sometimes reactive hypoglycemia and acromegaly, or rarer disorders of carbohydrate metabolism. In the most commonly performed version of the test, an oral glucose tolerance test (OGTT), a standard dose of glucose is ingested by mouth and blood levels are checked two hours later.[3] Many variations of the GTT have been devised over the years for various purposes, with different standard doses of glucose, different routes of administration, different intervals and durations of sampling, and various substances measured in addition to blood glucose. History[edit] The glucose tolerance test was first described in 1923 by Jerome W. Conn.[4] The test was based on the previous work in 1913 by A. T. B. Jacobson in determining that carbohydrate ingestion results in blood glucose fluctuations,[5] and the premise (named the Staub-Traugott Phenomenon after its first observers H. Staub in 1921 and K. Traugott in 1922) that a normal patient fed glucose will rapidly return to normal levels of blood glucose after an initial spike, and will see improved reaction to subsequent glucose feedings.[6][7] Testing[edit] Since the 1970s, the World Health Organization and other organizations interested in diabetes agreed on a standard dose and duration. Preparation[edit] The patient is instructed not to restrict carbohydrate intake in the days or weeks before the test.[citation needed] The test should not be done during an illness, as results may not reflect the patient's glucose metabolism when healthy. A full adult dose should not be Continue reading >>

Glucose Screening And Glucose Tolerance Tests

Glucose Screening And Glucose Tolerance Tests

Why do I need a glucose screening test during pregnancy? Most healthcare practitioners routinely recommend a glucose screening test (also called a glucose challenge test or GCT) between 24 and 28 weeks of pregnancy to check for gestational diabetes. Gestational diabetes is a high blood sugar condition that some women get during pregnancy. Between 2 and 5 percent of expectant mothers develop this condition, making it one of the most common health problems during pregnancy. And because the condition rarely causes any symptoms, testing is the only way to find out whether you have it. Like any screening test, the GCT won't give you a diagnosis. Instead, it's designed to identify as many women as possible who may have a problem and need more testing to find out. So a positive result doesn't mean that you have gestational diabetes. In fact, only about a third of women who test positive on the glucose screen actually have the condition. If you test positive on the screening, you'll need to take the glucose tolerance test (GTT) – a longer, more definitive test that tells you for sure whether you have gestational diabetes. Your practitioner may want you to be screened earlier than 24 weeks if a routine urine test shows a lot of sugar in your urine or if you're considered high risk. If the results are normal, you'll be screened again at 24 to 28 weeks. Of course, if you were diagnosed with diabetes before pregnancy, you won't need to be screened. Instead, you'll continue to work with your practitioner to manage your condition during pregnancy. How is the glucose screening test done? When you arrive for the test, you're given a sugar solution that contains 50 grams of glucose. The stuff tastes like a very sweet soda pop (it comes in cola, orange, or lime flavor), and you have to Continue reading >>

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes does not increase the risk of birth defects or the risk that the baby will be diabetic at birth. Also called gestational diabetes mellitus (GDM), this type of diabetes affects between 3% and 20% of pregnant women. It presents with a rise in blood glucose (sugar) levels toward the end of the 2nd and 3rd trimester of pregnancy. In 90% if cases, it disappears after the birth, but the mother is at greater risk of developing type 2 diabetes in the future. Cause It occurs when cells become resistant to the action of insulin, which is naturally caused during pregnancy by the hormones of the placenta. In some women, the pancreas is not able to secrete enough insulin to counterbalance the effect of these hormones, causing hyperglycemia, then diabetes. Symptoms Pregnant women generally have no apparent diabetes symptoms. Sometimes, these symptoms occur: Unusual fatigue Excessive thirst Increase in the volume and frequency of urination Headaches Importance of screening These symptoms can go undetected because they are very common in pregnant women. Women at risk Several factors increase the risk of developing gestational diabetes: Being over 35 years of age Being overweight Family members with type 2 diabetes Having previously given birth to a baby weighing more than 4 kg (9 lb) Gestational diabetes in a previous pregnancy Belonging to a high-risk ethnic group (Aboriginal, Latin American, Asian or African) Having had abnormally high blood glucose (sugar) levels in the past, whether a diagnosis of glucose intolerance or prediabetes Regular use of a corticosteroid medication Suffering from ancanthosis nigricans, a discoloration of the skin, often darkened patches on the neck or under the arms Screening The Canadian Diabetes Association 2013 Clinical Practice Gui Continue reading >>

Glucose Tolerance Test 2-hour (75 Gm)

Glucose Tolerance Test 2-hour (75 Gm)

CPT Code(s) 82951 Includes Fasting, 1-Hour, 2-Hour glucose Patient Preparation Fasting is required Preferred Specimen(s) 5 mL whole blood collected in a sodium floride (gray-top) tube for each determination Collection Instructions Draw a fasting sample first. Patient to be given 75 gm dose of glucola after fasting specimen is drawn. Draw the second sample 1 hour after the patient finishes drinking the glucola. Draw third sample 1 hour after the second draw. If patient is under 95 pounds, call the laboratory for special dosing procedure for glucola. Indicate collection time on each sample container. Transport Container Original collection tube(s) for each draw Transport Temperature Refrigerated (cold packs) Specimen Stability Room temperature: 24 hours Refrigerated: 7 days Frozen: 30 days Methodology Spectrophotometry (SP) Setup Schedule Set up: Daily; Report available: 1 day Limitations Glucose levels may be depressed if sample is left on clot for an excessive length of time. Reference Range(s) American Diabetes Association Diagnostic Criteria for Diabetes Mellitus Glucose Value (mg/dL) Interpretation Fasting 1-Hr Tolerance 2- Hr Tolerance Normal <100 Not established <140 Impaired Fasting 100-125 Impaired Tolerance 140-199 Diabetes ≥126* ≥200* *Must be confirmed by testing on a subsequent day. Clinical Significance This test is used for the routine diagnosis of diabetes in children and the non-pregnant adult. For pregnant females see test "Glucose Tolerance Test, Gestational, 4 Specimens (100 g)". For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose. Immediately after, a fasting specimen is obtained. For children, the glucose load is 1.75 g/Kg of body weight, up to 75. The diagnosis of diabetes is made if the Continue reading >>

Glucose Test During Pregnancy For Gestational Diabetes

Glucose Test During Pregnancy For Gestational Diabetes

Congratulations! A baby is on the way. Your nine months will be filled with preparations, from decorating the nursery to stocking up on bibs and booties to going for regular checkups to ensure that you and your baby are as healthy as possible. One of the tests that you’ll have during this time is to check for gestational diabetes. A few weeks ago, we looked at Type 1 and Type 2 diabetes. Gestational diabetes, which is growing more common among pregnant women, will be our focus this week. What is gestational diabetes? Gestational diabetes, or GDM for short, is diabetes that occurs during pregnancy. In fact, it only occurs during pregnancy. (Gestational diabetes is not the same as diabetes in women who have existing diabetes and become pregnant). Diabetes, as most of you know, is a condition in which blood glucose levels go too high. High blood glucose levels can be harmful to you and, in the case of pregnancy, to your unborn child. Fortunately, blood glucose, or sugar, levels can be controlled during pregnancy, and in most instances, high blood sugar levels return to normal after the baby is delivered. According to the National Institutes of Health, up to 10% of pregnant women in the United States have gestational diabetes. What causes gestational diabetes? A lot of changes occur in the body during pregnancy, many of them occurring due to widely fluctuating hormone levels. The placenta, which is what connects the baby to the mother’s uterine lining, makes various hormones, and while this is a good thing, these hormones can sometimes make it hard for the body’s insulin to work properly (a condition called insulin resistance). As a result, blood sugar levels can start to climb in women who cannot produce enough insulin to deal with the insulin resistance. How do you Continue reading >>

Glucose Tolerance Test

Glucose Tolerance Test

What is a glucose tolerance test? A glucose tolerance test measures how well your body’s cells are able to absorb glucose, or sugar, after you ingest a given amount of sugar. Doctors use fasting blood sugar levels and hemoglobin A1c values to diagnose type 1 and type 2 diabetes, and prediabetes. A glucose tolerance test can also be used. Doctors primarily use a glucose tolerance test to diagnose gestational diabetes. Doctors often diagnose type 1 diabetes quickly because it usually develops quickly and involves high blood sugar levels. Type 2 diabetes, on the other hand, often develops over years. Type 2 diabetes is the most common form of diabetes, and it usually develops during adulthood. Gestational diabetes occurs when a pregnant woman who doesn’t have diabetes before pregnancy has high blood sugar levels as a result of the pregnancy. The American Diabetes Association estimates that gestational diabetes occurs in 9.2 percent of pregnancies. Doctors should screen all women for gestational diabetes. Gestational diabetes can cause pregnancy complications, so early detection and prompt treatment are important. If you’re pregnant, your doctor will usually recommend this test between the 24th and 28th week of your pregnancy. Your doctor may also recommend that you have this test earlier if you’re having the symptoms of prediabetes or diabetes. Preparing for the glucose tolerance test involves the following: Continue to eat a normal diet in the days leading up to the test. Consult with your doctor about any medications you’re currently taking. Some medications, such as corticosteroids, beta-blockers, diuretics, and antidepressants, can interfere with the results. Abstain from food for at least eight hours before the scheduled test. You may drink water, but avoid Continue reading >>

Gestational Diabetes

Gestational Diabetes

What Is Gestational Diabetes? Gestational diabetes sometimes develops when a woman is pregnant. It’s when the blood glucose level (blood sugar level) of the mother goes too high during pregnancy. Having an elevated blood glucose level during pregnancy can cause problems for your baby—if it’s left untreated. Fortunately, doctors are vigilant about checking for gestational diabetes so that it can be identified and effectively managed. A pro-active treatment plan helps you have a good pregnancy and protects the health of your baby. Gestational Diabetes Symptoms Gestational diabetes doesn’t often cause noticeable symptoms for the mother. Other types of diabetes (eg, type 1 diabetes or type 2 diabetes) do cause symptoms such as increased thirst, but that is hardly ever noticed in gestational diabetes. Because there aren’t often symptoms, it’s very important to be tested for a high blood glucose level when you’re pregnant. (Your doctor will most likely test you for gestational diabetes sometime between the 24th and 28th week. You can learn more about the diagnostic process here.) Then your doctor will know if you need to be treated for gestational diabetes. Gestational Diabetes Causes and Risk Factors Gestational diabetes develops when your body isn’t able to produce enough of the hormone insulin during pregnancy. Insulin is necessary to transport glucose—what your body uses for energy—into the cells. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps gestational diabetes. The elevated blood glucose level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also Continue reading >>

The Prognostic Value Of A Normal Oral Glucose Tolerance Test In Pregnant Women Who Tested Positive At Screening: A Validation Study

The Prognostic Value Of A Normal Oral Glucose Tolerance Test In Pregnant Women Who Tested Positive At Screening: A Validation Study

The prognostic value of a normal oral glucose tolerance test in pregnant women who tested positive at screening: a validation study 1School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil 2Department of Obstetrics & Gynecology, School of Medical Sciences, University of Campinas, Campinas, So Paulo, Brazil 1School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil 3The Prof. Dr. Jos A. Pinotti Women's Hospital, a Teaching Hospital of the University of Campinas (UNICAMP), Campinas, So Paulo, Brazil 1School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil 3The Prof. Dr. Jos A. Pinotti Women's Hospital, a Teaching Hospital of the University of Campinas (UNICAMP), Campinas, So Paulo, Brazil 1School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil 2Department of Obstetrics & Gynecology, School of Medical Sciences, University of Campinas, Campinas, So Paulo, Brazil 3The Prof. Dr. Jos A. Pinotti Women's Hospital, a Teaching Hospital of the University of Campinas (UNICAMP), Campinas, So Paulo, Brazil Received 2011 Nov 1; Accepted 2012 Apr 3. Copyright 2012 Rehder et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Controversies surround a diagnosis of gestational diabetes mellitus (GDM). The objective of this study was to evaluate the oral glucose tolerance test (OGTT) for the prediction of adverse gestational and perinatal outcomes in pregnant women with a positive screening test for diabetes mellitus and a negative diagnosis, i.e. a normal 3-hour OGTT. This v Continue reading >>

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