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Glucose Tolerance Test- 2 Hrs (5 Samples)

Diabetes
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Report in 4Hrs

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At Home

fastingrequire

Fasting Required

Details

Checks glucose metabolism.

₹185₹264

30% OFF

Glucose Tolerance Test - 2 Hrs (5 Samples)

  • Why is it done?
    • Screens for gestational diabetes mellitus (GDM) during pregnancy, typically between 24-28 weeks of gestation
    • Diagnoses impaired glucose tolerance and Type 2 diabetes mellitus in non-pregnant individuals
    • Evaluates the body's ability to regulate blood glucose levels after oral glucose challenge
    • Identifies individuals at risk for metabolic syndrome and cardiovascular disease
    • Assesses insulin secretion and glucose homeostasis in patients with family history of diabetes
    • Performs 5 blood draws: fasting, 30 minutes, 60 minutes, 90 minutes, and 120 minutes post-glucose load
  • Normal Range
    • Fasting Blood Glucose (0 min): 70-100 mg/dL (3.9-5.6 mmol/L)
    • 30-Minute Sample: <200 mg/dL (<11.1 mmol/L) - typically peaks at this interval
    • 60-Minute Sample: <200 mg/dL (<11.1 mmol/L)
    • 90-Minute Sample: <150 mg/dL (<8.3 mmol/L) - glucose levels begin declining
    • 120-Minute Sample (2-Hour): <140 mg/dL (<7.8 mmol/L) - normal fasting glucose restored
    • Interpretation Guide:
    • Normal (NGT - Normal Glucose Tolerance): 2-hour value <140 mg/dL and all intermediate values within normal limits
    • Impaired Glucose Tolerance (IGT): 2-hour value 140-199 mg/dL with fasting glucose <126 mg/dL
    • Diabetes Mellitus: 2-hour value ≥200 mg/dL or fasting ≥126 mg/dL (confirmatory test required)
    • For Gestational Diabetes (GDM screening): Special criteria apply; typically ≥140 mg/dL at 1-hour screening, 50g OGCT
  • Interpretation
    • Normal Glucose Tolerance (NGT): Demonstrates efficient pancreatic beta-cell function with appropriate insulin secretion. Glucose levels return to baseline within 2 hours, indicating excellent metabolic control and minimal diabetes risk.
    • Impaired Glucose Tolerance (IGT): Indicates reduced pancreatic reserve and delayed glucose clearance. Represents a prediabetic state with significant risk for progression to Type 2 diabetes (approximately 3-10% annual conversion rate). Requires lifestyle modifications and regular monitoring.
    • Impaired Fasting Glucose (IFG): Fasting glucose 100-125 mg/dL with normal 2-hour values indicates hepatic insulin resistance. Associated with increased cardiovascular risk and metabolic syndrome.
    • Diabetes Mellitus (DM): 2-hour value ≥200 mg/dL confirms significant pancreatic dysfunction with severe insulin deficiency or resistance. Requires medical intervention, pharmacotherapy consideration, and intensive lifestyle changes.
    • Factors Affecting Results:
    • Medications: Steroids, thiazide diuretics, beta-blockers, and antipsychotics can elevate glucose levels
    • Stress and illness: Acute infections, hormonal changes, and emotional stress increase cortisol and impair glucose tolerance
    • Physical inactivity: Sedentary lifestyle impairs glucose clearance and insulin sensitivity
    • Recent dietary changes: High carbohydrate or high glycemic index diet in days preceding test can affect results
    • Age and obesity: Advancing age and increased BMI are associated with delayed glucose clearance
    • Pregnancy: Hormonal changes and gestational diabetes significantly alter glucose tolerance
  • Associated Organs
    • Primary Organs Involved:
    • Pancreas: Beta-cells produce insulin in response to glucose; dysfunction leads to impaired glucose tolerance and diabetes
    • Liver: Primary site of glucose production and storage; hepatic insulin resistance impairs glucose suppression
    • Muscle and adipose tissue: Primary sites of glucose uptake; insulin resistance reduces glucose utilization
    • Kidneys: Involved in glucose reabsorption and regulation; diabetic nephropathy is a major complication
    • Associated Conditions and Diseases:
    • Type 2 Diabetes Mellitus: Progressive disorder requiring long-term management with medications, lifestyle changes, and monitoring
    • Gestational Diabetes Mellitus (GDM): Increases maternal and fetal morbidity; associated with preeclampsia, macrosomia, and neonatal hypoglycemia
    • Metabolic Syndrome: Cluster including hypertension, dyslipidemia, obesity, and insulin resistance
    • Polycystic Ovary Syndrome (PCOS): Associated with insulin resistance and impaired glucose tolerance
    • Acanthosis Nigricans: Skin manifestation of severe insulin resistance
    • Potential Complications:
    • Microvascular complications: Retinopathy, nephropathy, and neuropathy from chronic hyperglycemia
    • Macrovascular complications: Coronary artery disease, cerebrovascular disease, and peripheral vascular disease
    • Cardiovascular disease: Diabetes increases risk of myocardial infarction and sudden cardiac death
    • End-stage renal disease: Prolonged diabetes leads to glomerulosclerosis and kidney failure
  • Follow-up Tests
    • If Normal Results (NGT):
    • Routine glucose monitoring: Every 3 years if age ≥45 or earlier if risk factors present
    • Fasting Blood Glucose (FBG): Screening test annually for surveillance
    • If Impaired Glucose Tolerance (IGT):
    • Repeat OGTT: Every 1-2 years to assess progression and response to interventions
    • HbA1c (Glycated Hemoglobin): Reflects 2-3 month average glucose levels; target <5.7%
    • Lipid Panel: Assess cardiovascular risk including total cholesterol, LDL, HDL, triglycerides
    • Blood Pressure Monitoring: Screen for hypertension development
    • Fasting Insulin Level: Optional to assess degree of insulin resistance
    • If Diabetes Mellitus (DM) is Diagnosed:
    • HbA1c Testing: Every 3-6 months initially, then quarterly once goal achieved; target <7% for most patients
    • Fasting Blood Glucose: Monthly monitoring until glycemic control established
    • Home Glucose Monitoring: Daily glucose logs and blood glucose meter use
    • Lipid Panel: Annually or more frequently if abnormal; manage dyslipidemia aggressively
    • Urine Microalbumin/Creatinine Ratio: Annually to screen for early diabetic nephropathy
    • Serum Creatinine and eGFR: Assess renal function and adjust medications accordingly
    • Comprehensive Metabolic Panel (CMP): Electrolytes, liver function, kidney function every 6-12 months
    • Ophthalmology Referral: Annual dilated eye exam to screen for diabetic retinopathy
    • EKG/Cardiac Testing: If additional cardiovascular risk factors present; baseline in older patients
    • Foot Examination: Annual comprehensive foot exam to assess for neuropathy and foot ulcer risk
    • For Gestational Diabetes (GDM):
    • Fetal monitoring: Increased ultrasound frequency, non-stress testing, and fetal growth assessment
    • Home glucose monitoring: Multiple times daily (fasting and post-meals); target <95 mg/dL fasting, <140 mg/dL postprandial
    • Post-partum OGTT: 6-12 weeks after delivery to determine if diabetes resolves; if normal, repeat every 3 years
    • Long-term glucose monitoring: Annual screening due to 50% risk of Type 2 diabetes development within 10-20 years
  • Fasting Required?
    • Fasting Status: YES - Fasting is REQUIRED
    • Fasting Duration: Minimum 8-10 hours, preferably overnight fast (typically 8 pm evening to 8 am following morning)
    • Dietary Restrictions:
    • No food consumption from midnight until after fasting blood draw (typically before 8-9 am)
    • No alcoholic beverages for 24 hours prior to testing
    • No high-carbohydrate or high-calorie meals the day before testing; maintain normal diet for 3 days prior
    • Fluid Intake:
    • Water only permitted during fasting period; unrestricted water intake encouraged to maintain hydration
    • No coffee, tea, juice, or carbonated beverages during fasting (even without sugar, caffeine can affect results)
    • Medication Management:
    • Continue regular medications UNLESS specifically instructed otherwise by physician
    • Notify laboratory/physician of all medications, especially: steroids, beta-blockers, diuretics, antipsychotics, or medications affecting glucose metabolism
    • Diabetic patients taking anti-diabetic medications should consult physician regarding medication timing on test day
    • Physical Activity:
    • Avoid strenuous exercise for 24 hours before testing; can significantly alter glucose levels and insulin sensitivity
    • Walk from parking area to test location is acceptable; minimize physical exertion on testing morning
    • Additional Patient Preparation:
    • Stress management: Minimize psychological stress; cortisol elevation can impair glucose tolerance
    • Sleep: Obtain adequate sleep night before testing; sleep deprivation impairs insulin sensitivity
    • Illness: Reschedule test if ill with acute infection or fever; acute illness alters glucose metabolism
    • Smoking: Avoid smoking for at least 1 hour before test; can elevate glucose and heart rate
    • Appointment timing: Schedule for early morning (7-9 am) when cortisol levels are highest and baseline glucose typically lowest
    • Glucose drink: Laboratory will provide standardized 75g glucose load in liquid form; must be consumed within 5 minutes
    • Duration: Plan for 3-hour appointment (1 hour for baseline draw and glucose load, then 2 hours of testing with draws at 30, 60, 90, 120 minutes)

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