葡萄糖耐量试验（Glucose tolerance test）

葡萄糖耐量试验（Glucose tolerance test） 葡萄糖耐量试验(Glucose tolerance test) 1. glucose tolerance test (OGTT) Objective: to determine whether there is any abnormal glucose metabolism. test method The following method of glucose tolerance test: 1. OGTT 3 days before the test, stop the insulin treatment, normal diet, carbohydrate content in the daily diet should not be less than 150 grams (but should be controlled at 250 ~ 300 grams, and maintain the normal activity range). 2. the next morning fasting fasting blood 2ml, anticoagulant, plasma glucose measurement, this is fasting blood sugar. 3. in 5 minutes to drink 300 ml containing 75 grams of glucose syrup (for children in per kg body weight to 1.75 grams of glucose, oral glucose dosage calculation, up to 75 grams of glucose only), drink syrup after 30 minutes, 1 hours and 2 hours respectively. Venous blood samples were collected once. Urine glucose test. Do not smoke, drink coffee, drink tea or eat during the experiment. Sit quietly on the chair. 4. determine the blood sugar concentration and draw the sugar resistance curve: draw the glucose tolerance curve by mapping the measured blood glucose concentration with the corresponding time. Edit the normal reference value of this paragraph The normal reference value is shown in the following table: the glucose limit (mmol/L) time limit (age) of glucose tolerance in different age groups, under 40 years of age, 40~49 years old, 50~59 years old, 60~69 years old and over 70 years old Fasting 6.9, 6.9, 6.9, 6.9, 6.9 3011.1, 11.1, 11.4, 11.55, 11.9 6010.54, 10.54, 11.1, 11.55, 12.2 1208.33, 8.33, 8.6, 8.88, 9.16 1806.9, 6.9, 6.9, 6.9, 6.9 Edit this paragraph OGTT results can be broadly divided into the following situations (1) normal glucose tolerance: fasting blood glucose <6.1mmol / L (110mg / dl); oral glucose 30min ~ 60min and reached the peak peak value of <11.1mmol / L (200mg / dl); 120min recovered to a normal level, <7.8mmol / L (140mg / dl), urine were (a). The sugar tolerance curve shows that the body has a good capacity for sugar load. (2) diabetes mellitus: fasting glucose tolerance was 7.0mmol / L (126mg / dl); peak time delay, often appear in the 1 hours after the peak of more than 11.1mmol / L (200mg / dl); 120min can not return to normal levels, namely >7.8mmol / L (140mg / dl) which take the blood glucose level 2H sugar is the most important indicator. Many of the early diabetic patients, only showed elevated blood glucose level of 2 hours, and the urine is often positive. Diabetes mellitus, such as obesity, pregnancy, hyperthyroidism, and the use of sugar cortisol hormone therapy or steroid contraceptives, can increase impaired glucose tolerance. (3) impaired glucose tolerance (IGT): This is a mild decline in glucose tolerance. In non pregnant adults, fasting blood glucose levels ranged from 6.11 to 7.Ommol / L (110 to 126mg / dl), and 120min glucose levels ranged from 7.8 to 11.1mmol / L (140 to 200mg / dl). The long-term follow-up of IGT patients resulted in about 1 / 3 return to normal, 1 / 3 still impaired glucose tolerance, and 1 / 3 eventually became diabetic. But these patients are not susceptible to diabetes specific microvascular lesions, such as retinal or glomerular microvascular disease, blindness or nephropathy, and prone to small vascular complications, such as coronary or cerebrovascular disease (coronary heart disease or stroke). (4) other glucose tolerance 1) flat type sugar tolerance curve: its curve characteristics are: (1) fasting blood sugar level is normal; after sugar load, no blood sugar rise in normal form. No blood glucose peak curve flat; and a relatively short period of time (usually 1 hours) to restore the original value of blood glucose. May be due to delayed gastric emptying, intestinal malabsorption caused by. Or pituitary, adrenal cortical hypofunction, hypothyroidism and excessive insulin secretion. At this time, because of the decrease of gluconeogenesis, the increase of sugar utilization in the tissues showed an increase in glucose tolerance. 2) the delay type sugar tolerance curve: characterized by the rapid rise in blood sugar level after taking sugar, the peak value appears earlier, and exceeds 11.1mmol / L, while the 2H value is lower than the fasting level. This is the hyperglycemia due to gastric resection in rapid intestinal absorption of glucose or severe liver damage in patients with liver glucose uptake and processing can not be quickly, caused by reactive insulin secretion, the liver tissues using glucose accelerated, the blood glucose decreased obviously 2h. Edit the paragraph and judge the result After taking glucose, each time limit blood sugar or fasting blood sugar, high peak value and 2 hours blood sugar value is bigger than the corresponding age's normal upper limit, may diagnose diabetes. If one or more of the blood sugar above the normal limit, and not reached the standard of diabetes, the abnormal glucose tolerance. Each time limit blood sugar is within the normal upper limit, is normal. Edit this paragraph clinical significance 1.OGTT is helpful in the diagnosis of latent diabetes mellitus. It can also simplify OGTT in practical application, that is, only 2 hours after fasting and taking sugar to determine the blood sugar value, it is generally considered that the value of 2 hours is critical. 2. endocrine disorders, such as adrenocortical diseases (such as Cushing syndrome), 70%~80% patients have impaired glucose tolerance; whereas adrenal dysfunction, pituitary insufficiency, can show low glucose tolerance curve. 3. chronic pancreatitis patients often showed diabetes curve. 4. liver disease, chronic hepatitis patients may appear impaired glucose tolerance. 5. impaired glucose tolerance may occur in the acute phase of myocardial infarction, which may be related to the stress status of the patient. 6., obesity may have an abnormal glucose tolerance curve, which is often impaired by the fact that fat cells are not sensitive to insulin. Simple obesity or normal glucose tolerance or a flat curve. 7. renal diabetes: as the renal tubular reabsorption function reduced, the kidney sugar threshold decreased, so that the normal concentration of glucose in the glomerular filtrate can not completely re absorption, at this time of diabetes, referred to as renal diabetes. 8., after acute hepatitis patients take glucose, between 0.5 to 1.5 hours, blood sugar increased rapidly, more than normal. Edit the main indications of this paragraph 1. without diabetes symptoms, random or impaired fasting glucose; 2. had no symptoms of diabetes, or persistent diabetes; 3. without diabetes symptoms, but there is a family history of diabetes was 4.; the symptoms of diabetes, but not fasting blood glucose or random diagnostic criteria; 5. pregnancy, thyroid function hyperthyroidism, liver disease, infection, diabetes appeared; 6. women delivered huge fetus or fetal macrosomia in the history of the individual; 7. unexplained nephropathy or retinopathy. Edit the notes in this paragraph (1) OGTT is affected by many factors, such as age, diet, health status, gastrointestinal function, certain drugs and mental factors. False positive seen in malnutrition, bedridden, nervous, acute and chronic disease; oral contraceptives, glucocorticoids, thyroid hormones, nicotinic acid, phenytoin sodium, diuretics and monoamine oxidase inhibitors. (2) for patients with gastrointestinal surgery or gastrointestinal disorders that affect glucose absorption, the glucose tolerance test should not be administered orally, but the IGTT glucose tolerance test (invein glucose, tolerance, test) should be used. For normal 0GTT but with a family history of diabetes, cortisone 0GTT may be administered, but the tolerance of glucose to glucose over the age of 50 is decreasing, so this test is not appropriate. (3) the glucose tolerance test can reflect the recent glucose metabolism in the body, but it is affected by many factors, such as age, diet, labor, stress, drugs, gastrointestinal function, sampling and glucose determination methods, etc..