BPT GTT & Diabetes Mellitus

GLUCOSE TOLERANCE TEST
(GTT)
GLUCOSE TOLERANCE TEST (GTT)
The diagnosis of diabetes the basis of individual’s response to
oral glucose load, the oral glucose tolerance test (OGTT).
Preparation of the subject for GTT:
• The person should have been taking carbohydrate-rich diet
for at least 3 days prior to the test.
• All drugs known to influence carbohydrate metabolism
should be discontinued (for at least 2 days).
• The subject should avoid strenuous exercise on the
previous day of the test.
• He/she should be in an overnight (at least 10 hr) fasting
state.
• During the course of GTT, the person should be
comfortably seated and should refrain from smoking and
exercise.
• Procedure for GTT
Glucose tolerance test should be conducted
preferably in the morning (ideal 9 to 11 AM).
A fasting blood sample is drawn and urine
collected.
The subject is given 75 g glucose orally, dissolved
in about 250-300 ml of water, to be drunk in
about 5 minutes.
Blood and urine samples are collected at 30
minute intervals for at least 2 hours.
All blood samples are subjected to glucose
estimation while urine samples are qualitatively
tested for glucose.
• Other relevant aspects of GTT
1. For conducting GTT in children, oral glucose is
given on the basis of weight (1.5 to 1.75 g/kg).
2. In case of pregnant women, 100 g oral glucose is
recommended. Further, the diagnostic criteria for
diabetes in pregnancy should be more stringent
than WHO recommendations.
Diabetes mellitus
Diabetes mellitus is a metabolic disease, more
appropriately a disorder of fuel metabolism. It is
mainly characterized by hyperglycemia that leads
to several long term complications.
Diabetes mellitus is broadly divided into 2 groups,
namely
insulin-dependent diabetes mellitus (IDDM) and
non-insulin dependent diabetes mellitus
(NIDDM).
This classification is mainly based on the
requirement of insulin for treatment.
• Insulin-dependent diabetes mellitus (IDDM)
IDDM, also known as type I diabetes or (less frequently)
juvenile onset diabetes, mainly occurs in childhood
(particularly between 12-15 yrs age). IDDM accounts for
about 10 to 20% of the known diabetics. This disease is
characterized by almost total deficiency of insulin due to
destruction of Beta-cells of pancreas.
• The Beta-cell destruction may be caused by drugs, viruses
or autoimmunity.
• Due to certain genetic variation, the Beta-cells are
recognized as non-self and they are destroyed by immune
mediated injury.
• Usually, the symptoms of diabetes appear when 80-90% of
the Beta-cells have been destroyed.
• The pancreas ultimately fails to secrete insulin in response
to glucose ingestion. The patients of IDDM require insulin
therapy
• Non-insulin dependent diabetes mellitus (NIDDM)
NIDDM, also called type II diabetes or (less frequently) adult-onset

diabetes, is the most common, accounting for 80 to 90% of the
diabetic population. NIDDM occurs in adults (usually above 35 years)
and is less severe than IDDM.
The causative factors of NIDDM include genetic and environmental.
NIDDM more commonly occurs in obese individuals. Overeating
coupled with underactivity leading to obesity is associated with the
development of NIDDM.
Obesity acts as a diabetogenic factor and leads to a decrease in insulin
receptors on the insulin responsive (target) cells. The patients of
NIDDM may have either normal or even increased insulin levels.
Many a times weight reduction by diet control alone is often sufficient to
correct NIDDM. Recent research findings on NIDDM suggest that
increased levels of tumor necrosis factor-Alpha (TNF-Alpha) and
resistin, and reduced seretion of adiponectin by adipocytes of obese
people cause insulin resistance (by impairing insulin receptor function).
• Glycosuria
The commonest cause of glucose excretion in
urine (glycosuria) is diabetes mellitus.
Therefore, glycosuria is the first line screening
test for diabetes. Normally, glucose does not
appear in urine until the plasma glucose
concentration exceeds renal threshold (180
mg/dl). As age advances, renal threshold for
glucose increases marginally.
HbA1c
Glycated hemoglobin :
• Glycated or glycosylated hemoglobin refers to
the glucose derived products of normal adult
hemoglobin (HbA). Glycation is a post-
translationaln, Non-enzymatic addition of
sugar residue to amino acids of proteins.
Among the glycated hemoglobins, the most
abundant form is HbA1c. HbA1c is produced
by the condensation of glucose with N-
terminal valine of each B-chain of HbA
Diagnostic importance of HbA1c :
• The rate of synthesis of HbA,. is directly
related to the exposure of RBC to glucose.
Thus, the concentration of HbA1. serves as an
indication of the blood glucose concentration
over a period, approximating to the half-life of
RBC (hemoglobin) i.e. 6-8 weeks. A close
correlation between the blood glucose and
HbA1c concentrations have been observed
when simultaneously monitored for several
months.
• Normally, HbA1c concentration is about 3-5%
of the total hemoglobin. ln diabetic patients,
HbA1c is elevated( to as high as 15%) .
PROTEINS
• Proteins are defined as sequence
specific polymers of aminoacids
linked by peptide bonds.
• It’s a complex organic substance

made up of carbon, hydrogen,
oxygen and nitrogen
Protein Structures
• Biochemists have distinguished
several levels of structural
organization of proteins. They
are:
– Primary structure
– Secondary structure
– Tertiary structure
– Quaternary structure
Aminoacid

BPT GTT & Diabetes Mellitus

Uploaded by

Copyright:

Available Formats

BPT GTT & Diabetes Mellitus

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

BPT GTT & Diabetes Mellitus

Uploaded by

Copyright:

Available Formats

GLUCOSE TOLERANCE TEST

NIDDM, also called type II diabetes or (less frequently) adult-onset

• It’s a complex organic substance

You might also like