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Test Your Knowledge |
Oral
Glucose Tolerance Testing of Obese Patients
QuestionPatient
Barbara A: 35 yrs old, non-pregnant, weight 145 kg (305 lbs) with extreme
abdominal obesity, a metabolic syndrome candidate. How much oral glucose should
be use to test her glucose metabolism to determine a diagnosis of diabetes?
Answer:3. Use 1.75 grams of glucose per kilogram. 4. Use a High Carbohydrate Meal of at least 400 grams. For
adults, there are no recommendations from the American Diabetes Association
(ADA) or World Health Organization (WHO) to alter the dose of the oral glucose
challenge based on absolute body mass, lean body mass, or body surface area. At
one time, up to 100 grams of glucose were recommended for OGTTs. However, for
non-pregnant adults, ADA long ago standardized the dose to 75 grams. In
children, 1.75 grams of glucose are used per kilogram to a maximum dose of 75
grams. Also, there are no reference ranges for expected glucose responses to
different doses of glucose. Likewise, there are no reference ranges for expected
glucose responses in different weight individuals. In short, if we are going to
use the current ADA guidelines for the diagnosis of prediabetes or diabetes, a
75-gram OGTT should be performed. References
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