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Causes Of False Positive Glucose Tolerance Test

Glucose Tolerance Tests

Glucose Tolerance Tests

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also separate Diabetes in Pregnancy, Metabolic Syndrome, Managing Impaired Glucose Tolerance In Primary Care and Gestational Diabetes articles. The oral glucose tolerance test (OGTT) evaluates the efficiency of the body to metabolise glucose. For many years the OGTT was used as the 'gold standard' for diagnosis of diabetes. An increase in postprandial glucose concentration usually occurs before fasting glucose increases. Therefore, postprandial glucose is a sensitive indicator of the risk for developing diabetes and an early marker of impaired glucose tolerance. Evidence has suggested that, when compared with fasting blood glucose, an increased two-hour plasma glucose during an OGTT is a better predictor of both all-cause mortality and cardiovascular mortality or morbidity. However extensive patient preparation is necessary to perform an OGTT. Important conditions include, among others, ingestion of at least 150 g of dietary carbohydrate per day for three days prior to the test, a 10- to 16-hour fast, and commencement of the test between 7:00 am and 9:00 am. In addition, numerous conditions other than diabetes can influence the OGTT. Evidence also indicates a high degree of individual patient variability in the OGTT, with greater variability than fasting blood glucose. The lack of reproducibility, the inconvenience and the cost of the OGTT led to the recommendation that fasting blood glucose should be the preferred glucose-based diagnostic test[1]. De Continue reading >>

Not So Sweet – Glucose Tolerance Test And Gestational Diabetes Information

Not So Sweet – Glucose Tolerance Test And Gestational Diabetes Information

Between 24 and 28 weeks gestation, most OBs and midwives send pregnant woman for the dreaded glucose tolerance test (GTT). This one-hour test is designed to determine who is at risk for gestational diabetes. In this article, I will detail everything you need to know about the test, what gestational diabetes is, and how to read the test results when you attain them. Let’s begin: What Is Gestational Diabetes? Gestational diabetes is a condition that affects three to five percent of pregnant women. The placenta, the organ responsible for nourishing the growing baby, produces pregnancy hormones that can interfere with the body’s ability to make or use insulin. In some women, gestational diabetes occurs when the pancreas over produces insulin to accommodate the insulin resistance caused by the placenta. Causing the need to produce up to three times the normal amount of insulin, gestational diabetes puts the woman at risk for a large baby at birth, preeclampsia, premature delivery, and type II diabetes later in life. Her baby will be at risk for hypoglycemia after birth and type II diabetes as it gets older. With proper diet and monitoring, the risks of gestational diabetes can be minimized. What to Expect During the Glucose Tolerance Test Women taking the one-hour GTT will receive a sugary drink with 50 grams of glucose. Three popular flavors of the drink include orange, fruit punch and lemon-lime. Many women describe the taste as flat soda or a melted popsicle. Pregnant women are given five minutes to finish the drink and will not be permitted to eat or drink anything else during the test. A nurse or lab technician will draw blood exactly one hour later. Although many women feel little side effects from the drink, some moms-to-be may get headaches or extreme fatigue fro Continue reading >>

Gestational Diabetes

Gestational Diabetes

Home The Diet Weekly Record Physiology FAQ Principles Special Needs No-Risk Diet Weight Gain Salt Water Bed Rest Herbal Diuretics Vegetarian Twin Pregnancy The Twin Diet Premature Labor Swelling Blood Pressure Pre-eclampsia HELLP/Hemorrhage Mistaken Diagnoses IUGR Underweight Babies Obesity Anemias Gestational Diabetes Abruption Brewer/ACOG Topics News Stories Inaccuracies Research In Memory Letters History Suppression Resources Other Issues Morning Sickness Colds and Flu About Contact Registry Registry II Registry III "Keep your nutritional needs clearly in mind" There is a summary and list of suggestions at the end of this page The following description of gestational diabetes is reprinted from The Brewer Medical Diet for Normal and High-Risk Pregnancy, by Gail Sforza Brewer [Krebs] with Thomas Brewer, M.D., published in 1983. While the standards recommended by the Diabetes Data Group may have been revised in more recent years to yet another, possibly even lower blood glucose level, which I will be researching in coming weeks, the principles advocated by Dr. Brewer in this reprint remain relevant. For an additional source on gestational diabetes, please see "Gestational Diabetes: Myth or Metabolism?", by Joy Jones, RN, which has been reprinted at the end of this page. For more information on testing for blood glucose and proper nutrition for apparently elevated blood glucose levels, please see Understanding Diagnostic Tests in the Childbearing Year, by Anne Frye, CPM, listed on our "Resources" page. Perhaps you can obtain a cop Continue reading >>

Gestational Diabetes Second Opinion On Test

Gestational Diabetes Second Opinion On Test

Gestational Diabetes second opinion on test Hi all. Just interested in your opinions regarding getting a second opinion for my gestational diabetes test. I'm 30 wks now and had my initial diabetes screening test done a couple of weeks ago. The healthy limit cut off is 7.8 and I got 7.9. I had a severe cold at the time of the test and my doctor told me later that being sick at the time of testing can elevate blood sugar levels. He then requested I have the secondary Glucose Tolerance Test done which is the fasting, eating special diet for 3 days and multiple blood tests over a 3 hour period. I've been avoiding getting the second test as I haven't been 100% well (and seems to be a lot to put myself through!), but as I'm feeling better now, I need to check again. I am thinking perhaps I might just see another doctor (my doc is away for 2 wks) and have the first screening test done again, rather then go through all the dramas of the much more intense GTT. Has anyone done the first test twice with different results or does everyone who 'fails' the first test just automatically go for the secondary testing? Thanks I think you SHOULD get the second test done. I failed my second test by 4 POINTS! I got BSL of over 12!!!! Just because you get diagnosed with GD does not mean you end up on insulin (however I did) but it does mean you are more closely monitored which IMHO is the best thing for bubs if you have GD. My Dr has always said that the GD test will show higher results if you are unwell but that is why the second test is over 3 hours as it shows how your body metabolises the sugar better as you will have 3 blood tests over that period. If it comes back marginally higher than you can always request another test. I had GD with my last pregnancy. The 1 hour (first test) is no Continue reading >>

A Physician's Experience With A False Positive Test Result

A Physician's Experience With A False Positive Test Result

Your wife has gestational diabetes. My heart stopped when my wifes physician called to tell me this. I want you to tell her because itll be easier to give it some time and let it sink in. Tell her to call me if she has any questions. But I had questions about a million. Let me give some background information. Im a third-year resident physician at a family medicine residency program. My wifes physician is a fantastic physician; hes one of my attendings, one of my mentors. Ive taken care of plenty of gestational diabetes during training, often with my wifes physician as my supervisory physician. But my wife is the epitome of health. She has run multiple half-marathons, she doesnt drink sodas, she watches her weight, she drinks over a liter of water a day. She rarely eats sweets, limits her breads, and she was 57, 130 lbs prior to pregnancy. Shes 29 years old. She has no family history of diabetes. So if she has gestational diabetes, what else could be wrong? Shes obviously not as healthy as we all thought. And so it began. I picked up a glucometer for her. We started checking her blood glucose. But something didnt seem quite right. Her blood glucose measurements were amazing. It was ridiculous how good they were. My wife kept asking me questions prior to this diagnosis, she thought she was healthy. She asked me what I thought was wrong with her. She asked me why her blood glucose seemed to be normal with the machine was the glucometer broken? I discussed it with my friends, they all comforted me, said things like, As long as the babys healthy, none of this will matter. Id talk about her normal glucose measurements, and they would say things like, Good tell her good job with her diabetes! I fought for her to get tested again. Turns out she doesnt have gestational diabete Continue reading >>

A Tale Of Low Carb Diets And Gestational Diabetes

A Tale Of Low Carb Diets And Gestational Diabetes

With the rising popularity of low carb/paleo type diets has come a curious unintended consequence: expecting mothers receiving a false positive on their Gestational Diabetes Mellitus (GDM) test. Gestational Diabetes Mellitus (GDM) GDM is diabetes (“Type 4 Diabetes”) diagnosed in the second or third trimester of pregnancy that is not obviously type 1 or 2 [1]. Women with diabetes in the first trimester would be classified as having type 2 diabetes [1]. The essential contributing factor to GDM is pancreatic insufficiency [2]. Basically, your pancreas is not making enough insulin for your body to overcome the increased insulin resistance due to the placental hormones of pregnancy and increased maternal adipose tissue, which could potentially cause your blood glucose levels to remain high. GDM = weak pancreas. Not making enough insulin for you and the baby. Testing There are two test for GDM: the one step and two step strategy. The One-Step test is the first test for diagnosing GDM. The diagnosis of GDM is made when any of the following plasma glucose values are met or exceeded [3]: Fasting: 92 mg/dL (5.1 mmol/L) 1 hour into the test: 180 mg/dL (10.0 mmol/L) 2 hours into the test: 153 mg/dL (8.5 mmol/L) If for whatever reason you do not pass the One-Step Oral Glucose Tolerance Test (OGTT), ask for the Two-Step test or ask them to check your HbA1C, as it shows blood sugar levels over time as opposed to the brief snapshot these one and two step tests provide. HbA1C can be measured with a simple blood test. The Two-Step test involves the following [3]: Step 1: Perform a 50-g Glucose Loading Test (GLT) (non-fasting), with plasma glucose measurement at 1 h. If the plasma glucose level measured 1 h after the load is ≥140 mg/dL (7.8 mmol/L), proceed to a 100-g OGTT. Step 2: Continue reading >>

Failed Glucose Test, Diagnosed With Gestational Diabetes, But Feel It Could Be A False Positive

Failed Glucose Test, Diagnosed With Gestational Diabetes, But Feel It Could Be A False Positive

Failed glucose test, diagnosed with gestational diabetes, but feel it could be a false positive I took the 1 hour glucose test yesterday (after fasting) and failed miserably with a 212. They didn't even want me to do the 3 hour test just diagnosed me with gestational diabetes. I am shocked to say the least. This is my 3rd, never had it with the others. I am a culinary arts teacher...I teach nutrition & cooking for a living, I eat well! The only aspect that could contribute is I am on little to no activity b/c of pre-term labor risks. Another weakness of mine is juice, I do drink a lot of juice but other than that I am a really healthy eater. Anyways I started testing today (pricking my finger 5 times a day & keeping a food journal) and my levels have all been good. I know it's too early to determine anything but I really think it may have been a false positive. Time will tell & I will keep testing & recording my food intake to share with my doctor but I was just wondering if anyone else has had a similar experience? If so please share... I don't think you can really do anything to cause GD or prevent. So I wouldn't attribute it to lack of activity. I thinks its ya have it or ya don't. Maybe talk to your OB if you are concerned. I forgot to add my weight gain has been "normal" or "average"17 lbs at 27 weeks and baby girl was measuring 2lbs 6oz today which is "normal" as well! I agree with kwitt318. I know lots of healthy, slender, balanced-eaters who had GD - some with only one of their pregnancies. It's not uncommon. It would be strange for you to have a false reading if you fasted prior to the 1-hour test as well. Fasting is not required prior to the 1-hour test. If you are still curious, I'm sure you could call your doctor & ask to do the 3-hour test. My 1 hr result Continue reading >>

Glucose Tolerance Test, The Gold Standard Prediabetes Test

Glucose Tolerance Test, The Gold Standard Prediabetes Test

The Glucose Tolerance Test For Prediabetes and More The glucose tolerance test is the best way to know if you are prediabetic. It is used to diagnose type 2 diabetes, the existence of borderline diabetes (prediabetes), and gestational diabetes during pregnancy. It is also called the GTT or OGTT (the O is for oral). This test will detect hyperglycemia (too much sugar in the blood), but it cannot diagnose hypoglycemia (too little sugar in the blood) even if your fasting blood sugar is unusually low. Your doctor cannot tell you that you have chronic hypoglycemia from a single blood test, unfortunately. But he can use the GTT to prove that you are becoming sensitive to glucose from insulin resistance, the symptom of prediabetes. How To Prepare For the Glucose Tolerance Test It is very important to eat your normal diet in the days before the test and to keep your activity level the same, too. If you eat an unusually large meal the day before the test or do not stick to your regular eating routine, the GTT results will be inaccurate. Illness and infections mess up the test too. Also, you need to let your doctor know all the medications you are on because they may affect the results. Other things that can make your GTT test a false positive for diabetes are stress, trauma, heart attack and stroke. Anything that involves your pancreas, such as pancreatitis, will change your results. This is why the American Diabetic Association recommends doctors do the glucose tolerance test twice to be sure it is accurate. Your doctor will tell you to fast the night before the test and skip breakfast. You need to be without food for at least 8 hours before the test begins. At your doctor visit, the nurse will give you a fingerstick blood test, which might hurt for a second. The glucose monit Continue reading >>

Gestational Diabetes Blood Sugar Testing In Pregnancy: Will You Be High Risk?

Gestational Diabetes Blood Sugar Testing In Pregnancy: Will You Be High Risk?

May 26, 2013 by Mary Earhart: Pregnancy, Childbirth 2 Comments Gestational diabetes risk differs by age, ethnicity, and many other factors are you at risk? Find out now, to avoid complications later! Image by Decoded Pregnancy Diabetes that begins and ends in pregnancy is called Gestational Diabetes. This term sets it apart from pre-existing disease, but may include women with mild to moderate high blood sugar, or hyperglycemia, during pregnancy. Recent controversies in glucose tolerance, or glucose challenge testing could mean that more pregnancies than ever before will be labeled with a diagnosis of gestational diabetes, which makes this subject an important one to women who want to have the healthiest pregnancy possible. Gestational Diabetes Testing Errors: False Positive, False Negative The American Diabetes Associations position statement of 2005 recommends that women with average risk be evaluated at 24 to 28 weeks of pregnancy by one of two testing approaches: For your initial screening, you do not need to be fasting. The lab gives you a 50 gram dose of glucose in a sweet-tasting drink you must consume all of it within ten minutes. The lab then draws your blood an hour later. If the result is normal, no further screening is necessary. Unfortunately, the one hour screening has a high incidence of false positive results. The next step is to determine whether you actually have gestational diabetes, if your first test was positive youll need to undergo a three-hour glucose challenge after youve been fasting for at least 8 hours. The lab will draw your blood before you drink a solution containing 100 grams of glucose, and the lab compares your level to subsequent draws taken at one, two and three hours. If two or more levels are above normal, doctors consider this a Continue reading >>

Glucose (urine)

Glucose (urine)

Does this test have other names? Urine glucose What is this test? A urine glucose test is used to indirectly determine whether your levels of glucose, or blood sugar, are within a healthy range. It's used to monitor both type 1 and type 2 diabetes. If your blood glucose rises above normal, your kidneys get rid of the extra glucose in your urine. That's why a urine glucose test may be able to determine whether your blood glucose is too high. Although easier to perform than a blood test, a urine test for glucose is not as accurate as a blood test. Urine tests are usually used only when blood testing for glucose is difficult or impossible. Why do I need this test? You may need this test if you have signs of diabetes. These include increased thirst, unexplained weight loss, increased urination, tiredness, blurred vision, and sores that don't heal. Sometimes people with prediabetes or diabetes don't have any symptoms. Your healthcare provider may check your glucose levels if you have risk factors for diabetes, including being overweight or obese, being physically inactive, having high blood pressure, having high cholesterol, or having a family history of diabetes. If you do not have these risk factors, but are age 45 or older, you should also be checked for diabetes at least every three years as long as your results are normal. If you are pregnant and are at risk of developing gestational diabetes, you may be screened frequently during and after your pregnancy. What other tests might I have along with this test? A urine glucose test may be done along with more sensitive and accurate blood tests. A urine test alone is not typically used to screen for or diagnose diabetes. Other tests that are used to screen for or diagnose diabetes or monitor blood glucose include blood gluco Continue reading >>

Gestational Diabetes

Gestational Diabetes

Source You may have heard of gestational diabetes, but what is this condition? During pregnancy, nutrient metabolism changes to nourish the growing baby. Pregnancy hormones and changes in the metabolism of sugar and the body's response to insulin tend to cause blood sugar to be higher than normal. Sometimes, these levels can become high enough to cause a woman to develop a diabetic condition during pregnancy - gestational diabetes - even though she is not normally diabetic. Pregnancy Induced Diabetes Some women develop diabetes for the first time during pregnancy (pregnancy-induced diabetes) and don't have it when they are not pregnant. However, other non-pregnant women might have a diagnosis of "borderline diabetes", or prediabetes, which worsens during pregnancy. In non-pregnant women with prediabetes, blood sugar levels are in the high range of normal. Then when they are pregnant, the metabolic changes of pregnancy raise their blood sugar levels high enough to tip them into overt gestational diabetes. Increased Maternal and Fetal Risks Gestational diabetes can cause severe adverse outcomes to mother and baby. The maternal complications include: An increased risk of hypertension A higher rate of pre-eclampsia A higher risk of cesarean section A risk that severe diabetes may develop The fetal risks include: Hydramnios, which is an excessive amount of amniotic fluid, also know as polyhydramnios The baby grows unusually large with excess fat deposits for its gestational age. This can lead to a difficult delivery. Hypoglycemia, meaning a condition of low blood sugar after birth A slightly higher rate of stillbirth for unknown reasons Difficulty breathing and jaundice at birth Close management and control of blood sugar levels will improve maternal and fetal outcomes. With Continue reading >>

Testing For Gestational Diabetes (gdm)

Testing For Gestational Diabetes (gdm)

Many women will be advised to take a screening test, called a Polycose Test, for Gestational Diabetes Mellitis at around 26 – 28 weeks of pregnancy. What is Gestational Diabetes Mellitis(GDM)? Gestational diabetes means diabetes (a condition in which blood sugar/glucose isn’t properly regulated) that is first diagnosed during pregnancy. Between 2 – 10% of pregnant women test positive for gestational diabetes mellitis (GDM). For half of these women this glucose intolerance will be a temporary condition that is only present during pregnancy. About 50% of women who test positive for GDM probably already had undiagnosed diabetes mellitus before they became pregnant. Many women will have higher than normal levels of blood sugar/glucose from time to time during pregnancy because pregnancy hormones suppress the release of the insulin (the hormone that regulates blood sugar levels), so that a pregnant woman’s blood sugar levels are hopefully consistently higher than the average adult’s. (Your baby needs a steady supply of glucose to meet her/his growth needs.) It is important that pregnant women eat regular small meals that provide for sustained glucose release rather than sugary snacks that cause short-term spikes in blood sugar levels. Prevention To reduce your risk of developing gestational diabetes you should:- Drink 5 – 8 glasses of water each day Drink a maximum of 3 drinks per day that contain caffeine and sugar (including unsweetened fruit juice). Exercise daily – make time for some low impact exercise each day e.g. walking, swimming, yoga, pilates. Eat regular small healthy meals – try to eat a meal that includes fresh vegetables, wholegrains and lean protein every 4 hours. Snack between meals if you need to but stick to healthy snacks e.g. fresh fruit, Continue reading >>

Glucola Pregnancy Glucose Test: What I Do

Glucola Pregnancy Glucose Test: What I Do

In my post about the pregnancy and prenatal care options I chose, I mention that I don’t take the pregnancy glucose test that requires drinking glucola (that syrupy orange or grape drink) and that I use an alternate method of testing. I’ve gotten so many questions about this that I decided it deserved its own post, especially while I am still pregnant and the topic is fresh on my mind. IMPORTANT: Please note that I am only writing about my own personal experience with this and the decisions I made after consulting with my OB or midwife (depending on which pregnancy it was). The information in this post (or any post I write) is not medical advice in any way… I’m just sharing my experience. Always consult with your own medical providers before making health decisions, especially during pregnancy, and make sure that you find providers who are willing to work with you to make the best decision for your pregnancy. All that being said, here’s what I do when it comes to the pregnancy glucose test. What is the Pregnancy Glucose Test? This was one of the sections I found in all of the many pregnancy books I read when pregnant with my first child. Current guidelines call for a glucose challenge test somewhere between 24-28 weeks of pregnancy to test for gestational diabetes. This test typically involves drinking a sweetened drink called Glucola that contains 50, 75, or 100 grams of sugar in different forms. In most cases, the first part of this test is an Oral Glucose Challenge Test (OGCT) that involves drinking the 50 gram solution and having a blood test exactly one hour later to measure blood sugar. If a woman passes this test, she typically won’t be given further testing for gestational diabetes. If a woman does not pass the test, a longer test involving a higher Continue reading >>

False-positive 1-hour Glucose Challenge Test And Adverse Perinatal Outcomes.

False-positive 1-hour Glucose Challenge Test And Adverse Perinatal Outcomes.

False-positive 1-hour glucose challenge test and adverse perinatal outcomes. Stamilio DM, et al. Obstet Gynecol. 2004. Center for Clinical Epidemiology and Biostatistics and Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA. [email protected] OBJECTIVE: To determine whether a false-positive 1-hour glucose challenge test (GCT) is associated with perinatal complications. METHODS: We performed a retrospective cohort study of 1825 eligible pregnant women among a cohort of 1998 patients. Patients were screened for gestational diabetes mellitus (GDM) with the 1-hour 50-g GCT at 24-28 gestational weeks. A false-positive GCT was defined as a result greater than or equal to 135 mg/dL followed by a normal 3-hour glucose tolerance test (GTT). We compared the negative GCT and false-positive GCT cohorts for a composite perinatal outcome variable that included fetal macrosomia, antenatal death, shoulder dystocia, chorioamnionitis, preeclampsia, intensive care nursery admission, and postpartum endometritis. Secondary outcomes included cesarean delivery and each component variable of the composite. Unadjusted, stratified, and multiple logistic regression analyses were used to investigate the association between a false-positive GCT and the development of perinatal complications. RESULTS: We identified 164 patients with a false-positive GCT and 50 patients with GDM. The false-positive GCT cohort on average was older, of higher parity, had a higher body mass index, and more frequently had chronic hypertension, sickle cell trait, and elevated midtrimester human chorionic gonadotropin levels. The false-positive GCT cohort more frequently had adverse perinatal outcomes, including the composite perinatal outcome Continue reading >>

“the Pregnant Mathematician” Drinks Glucola

“the Pregnant Mathematician” Drinks Glucola

Glucose Challenge Screen for Gestational Diabetes As I posted about a few days ago, this week I had a one-hour glucose challenge test to screen for Gestational Diabetes (GDM). Today I received a phone call from my OB’s office informing me that my results were back and they were within the “normal” levels. Getting a negative result is comforting, but then I went back to hunting for statistical data on what this result really means. According to an article I found in Obstetrics & Gynaecology, a 1994 study (“Poor sensitivity of the fifty-gram one-hour glucose screening test for hyperglycemia“) by van Turnhout HE, Lotgering FK, Wallenburg HC reported the sensitivity and specificity of the 1-hour glucose challenge test were 27% and 89%, respectively, with a prevalence rate of 5%. In statistics, sensitivity and specificity are markers of how good of a test you’re considering. The sensitivity of a test tells you, “Out of all the people who have the condition, what percent of them will test positive?” Similarly, the specificity of a test tells you, “Out of all the people who don’t have the condition, what percent of them will test negative?” If a test were perfect, we would expect both of these to be 100%. This would mean that 100% of people who have the condition really test positive, and 100% of the people who don’t have the condition really test negative. Of course, in the real world, this never really happens. What Can I Conclude? Another way we can gauge the performance of a test is to find its positive predictive value and its negative predictive value. I’m going to assume the sensitivity and specificity in the study cited above are correct. The same study above also gives a positive predictive value of 11% and a negative predictive value of 96%, Continue reading >>

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