Diagnostic value of the glucose tolerance test. How to carry out a glucose tolerance test (instruction, transcript) GTT analysis
Glucose tolerance test is a special study that makes it possible to check the performance of the pancreas. Its essence boils down to the fact that a certain dose of glucose is injected into the body and after 2 hours, blood is taken for analysis. Such a test may also be called a glucose load test, sugar load, GTT, and also GNT.
In the human pancreas, a special hormone insulin is produced, which can qualitatively monitor blood sugar levels and reduce it. If a person has diabetes, then 80 or even 90 percent of all beta cells will be affected.
Glucose tolerance test is oral and intravenous, and the second type is carried out extremely rarely.
Who needs to take the test?
A glucose tolerance test for sugar tolerance should be performed at normal and borderline glucose levels. This is important for differentiating diabetes mellitus and identifying the degree of glucose tolerance. This condition can also be called prediabetes.
In addition, a glucose tolerance test can be prescribed for those individuals who have had hyperglycemia at least once during stressful situations e.g. heart attack, stroke, pneumonia. GTT will be carried out only after the normalization of the condition of the sick person.
Speaking about the norms, then on an empty stomach a good indicator will be from 3.3 to 5.5 millimoles per liter of human blood, inclusive. If, as a result of the test, a figure above 5.6 millimoles is obtained, then in such situations we will talk about a violation of fasting glycemia, and with a result of 6.1, diabetes mellitus develops.
What to pay attention to?
It is worth noting that the usual results of the use of glucometers will not be indicative. They can provide fairly average results, and are recommended only during the treatment of diabetes in order to control the level of glucose in the patient's blood.
We must not forget that blood is taken from the cubital vein and the finger at the same time, and on an empty stomach. After eating, sugar is perfectly absorbed, which leads to a decrease in its level to as much as 2 millimoles.
The test is a rather serious stress test and that is why it is highly recommended not to perform it without special need.
For whom is a glucose tolerance test contraindicated?
The main contraindications for a glucose tolerance test include:
- severe general condition;
- inflammatory processes in the body;
- violations of the process of eating after surgery on the stomach;
- acid ulcers and Crohn's disease;
- acute abdomen;
- exacerbation of hemorrhagic stroke, cerebral edema and infarction;
- malfunctions in the normal functioning of the liver;
- insufficient intake of magnesium and potassium;
- the use of steroids and glucocorticosteroids;
- tableted contraceptives;
- Cushing's disease;
- hyperthyroidism;
- taking beta-blockers;
- acromegaly;
- pheochromocytoma;
- taking phenytoin;
- thiazide diuretics;
- use of acetazolamide.
How to prepare before the test?
In order for the results of the test for glucose resistance to be correct, it is necessary in advance, namely a few days before it, to eat only those foods that are characterized by normal or elevated level carbohydrates.
We are talking about the food in which their content is from 150 grams or more. If you follow a low-carbohydrate diet before the test, then this will be a serious mistake, because the result will be an excessively low indicator of the patient's blood sugar level.
In addition, about 3 days before the proposed study, the use of such drugs is not recommended: oral contraceptives, thiazide diuretics, and glucocorticosteroids. At least 15 hours before the GTT, you can not drink alcoholic beverages and eat food.
How is a glucose tolerance test performed?
Glucose tolerance test for sugar level is performed in the morning on an empty stomach. Also, you can not smoke cigarettes before the test and until the end of it.
First, blood is taken from the cubital vein on an empty stomach. After that, the patient should drink 75 grams of glucose, previously dissolved in 300 milliliters. pure water without gas. All liquid should be consumed within 5 minutes.
If we are talking about the child under study, then in this case, glucose is diluted at the rate of 1.75 grams per kilogram of the child's weight, and you need to know what it is. If its weight is more than 43 kg, then the standard dosage for an adult is necessary.
Glucose levels will need to be measured every half an hour to ensure that blood sugar peaks are not missed. At any such time, the level should not exceed 10 millimoles.
It is worth noting that during the glucose test, any physical activity and not just lying or sitting in one place.
Why are there false test results?
The following factors can lead to false negative results:
- impaired absorption of glucose into the blood;
- absolute restriction of oneself in carbohydrates on the eve of the test;
- excessive physical activity.
A false positive result can be obtained if:
- prolonged fasting of the studied patient;
- because of the pastel regime.
Interpretation of test results
According to the data of the World Health Organization from 1999, the results that a glucose tolerance test performed on the basis of whole capillary blood show will be as follows:
18 mg/dl = 1 millimol per liter of blood
100 mg/dl = 1 g/l = 5.6 mmol
dl \u003d deciliter \u003d 0.1 l.
On empty stomach:
- the norm will be considered: less than 5.6 mmol / l (less than 100 mg / dl);
- for impaired fasting glucose: from 5.6 to 6.0 mmol (100 to less than 110 mg / dl);
- for diabetes: the norm is more than 6.1 mmol / l (more than 110 mg / dl).
2 hours after glucose ingestion:
- normal: less than 7.8 mmol (less than 140 mg / dl);
- impaired tolerance: from the mark of 7.8 to 10.9 millimoles (starting from 140 to 199 mg / dl);
- diabetes mellitus: greater than 11 mmol (greater than or equal to 200 mg/dL).
When establishing the level of sugar from blood taken from the cubital vein, on an empty stomach, the indicators will be the same, and after 2 hours this figure will be 6.7-9.9 millimoles per liter.
Glucose tolerance test during pregnancy
The described glucose tolerance test will be incorrectly confused with that which is carried out in pregnant women in the period from 24 to 28 weeks of the term. It is prescribed by a gynecologist to identify risk factors for developing latent diabetes in pregnant women. In addition, such a diagnosis can be recommended by an endocrinologist.
In medical practice, there are various test options: one hour, two hours, and one that is designed for 3 hours. If we talk about those indicators that should be set when taking blood on an empty stomach, then these will be numbers not lower than 5.0.
If a woman in a position has diabetes mellitus, then in this case the indicators will speak about it:
- after 1 hour - more than or equal to 10.5 millimoles;
- after 2 hours - more than 9.2 mmol / l;
- after 3 hours - more than or equal to 8.
During pregnancy, it is extremely important to constantly monitor blood sugar levels, because in this position the child in the womb is subject to a double load, and in particular, his pancreas. Plus, everyone is interested in the question,.
The glucose tolerance test (GTT) is used not only as one of the laboratory methods for diagnosing diabetes, but also as one of the methods of self-monitoring.
Due to the fact that it reflects the level of glucose in the blood with the use of a minimum of funds, it is easy and safe to use not only for diabetics or healthy people, but also for pregnant women who are in a long period.
The relative simplicity of the test makes it easily accessible. It can be taken by both adults and children from 14 years old, and subject to certain requirements, the final result will be as clear as possible.
So, what is this test, why is it needed, how to take it, and what is the norm for diabetics, healthy people and pregnant women? Let's figure it out.
There are several types of tests:
- oral (OGTT) or oral (OGTT)
- intravenous (VGTT)
What is their fundamental difference? The fact is that everything lies in the method of introducing carbohydrates. A so-called “glucose load” is performed a few minutes after the first blood draw, and you will either be asked to drink sweetened water or an intravenous glucose solution will be given.
The second type of GTT is used extremely rarely, because the need to introduce carbohydrates into the venous blood is due to the fact that the patient is not able to drink sweet water himself. This need does not arise very often. For example, with severe toxicosis in pregnant women, a woman may be offered to carry out a “glucose load” intravenously. Also, in those patients who complain of gastrointestinal disorders, subject to a violation of the absorption of substances in the process of nutrient metabolism, there is also a need for forced administration of glucose directly into the blood.
GTT indications
The following patients who could be diagnosed, notice the following disorders can receive a referral for an analysis from a therapist, gynecologist or endocrinologist:
- suspicion of type 2 diabetes mellitus (in the process of making a diagnosis), in the actual presence of this disease, in the selection and adjustment of the treatment of "diabetes disease" (when analyzing positive results or lack of treatment effect);
- type 1 diabetes mellitus, as well as in the conduct of self-monitoring;
- suspicion of gestational diabetes or its actual presence;
- prediabetes;
- metabolic syndrome;
- some malfunctions in the work of the following organs: pancreas, adrenal glands, pituitary gland, liver;
- obesity;
- other endocrine diseases.
The test showed itself well not only in the process of collecting data for suspected endocrine diseases, but also in self-monitoring.
For such purposes, it is very convenient to use portable biochemical blood analyzers or glucometers. Of course, only whole blood can be analyzed at home. At the same time, do not forget that any portable analyzer allows a certain amount of errors, and if you decide to donate venous blood for laboratory analysis, the indicators will differ.
To conduct self-control, it will be enough to use compact analyzers, which, among other things, can reflect not only the level of glycemia, but also the volume of glycated hemoglobin (HbA1c). Of course, a glucometer is somewhat cheaper than a biochemical express blood analyzer, which expands the possibilities of self-monitoring.
Contraindications for GTT
Not everyone is allowed to take this test. For example, if a person has:
- individual glucose intolerance;
- diseases of the gastrointestinal tract (for example, there was an exacerbation of chronic pancreatitis);
- acute inflammatory or infectious disease;
- severe toxicosis;
- post-operative period;
- the need for bed rest.
GTT features
We have already understood under what circumstances you can get a referral for a laboratory glucose tolerance test. Now it's time to understand how to pass this test correctly.
One of the most important features is the fact that the first blood sampling is done on an empty stomach and how a person behaved before donating blood will certainly affect the final result. Thanks to this, the GTT can be safely called a "capricious", because it is affected by the following:
- the use of alcoholic beverages (even a small dose of drunk distorts the results);
- smoking;
- physical activity or lack thereof (whether you play sports or lead an inactive lifestyle);
- how much sugary food or water you consume (eating habits directly affect this test);
- stressful situations (frequent nervous breakdowns, experiences at work, at home during admission to an educational institution, in the process of gaining knowledge or passing exams, etc.);
- infectious diseases (ARI, ARVI, mild cold or runny nose, flu, tonsillitis, etc.);
- postoperative condition (when a person recovers from surgery, he is forbidden to take this species analyzes);
- reception medicines(affecting the mental state of the patient; hypoglycemic, hormonal, stimulating metabolism drugs and the like).
As we can see, the list of circumstances that affect the test results is very long. It is better to warn your doctor about the above.
In this regard, in addition to it or as a separate type of diagnosis,
It can also be taken during pregnancy, but it can show a falsely high result due to the fact that too fast and serious changes occur in the body of a pregnant woman.
How to take
This test is not so difficult, however, it lasts for 2 hours. The expediency of such a lengthy data collection process is justified by the fact that the level of glycemia in the blood is unstable, and the verdict that your doctor will ultimately give you depends on how it is regulated by the pancreas.
A glucose tolerance test is carried out in several stages:
1. Blood sampling on an empty stomach
This rule is a must! Fasting should last from 8 to 12 hours, but not longer than 14 hours. Otherwise, we will get unreliable results, because the primary indicator is not subject to further consideration and it will be impossible to compare the further increase and decrease in glycemia with it. That is why donate blood early in the morning.
Within 5 minutes, the patient either drinks a "glucose syrup" or is given a sweet solution intravenously (see).
With VGTT, a special 50% glucose solution is administered intravenously gradually over 2 to 4 minutes. Or prepare an aqueous solution to which 25 g of glucose is added. If we are talking about children, then sweet water is prepared at the rate of 0.5g / kg of ideal body weight.
With OGTT, OGTT, a person should drink sweet warm water (250 - 300 ml) in which 75 g of glucose is dissolved within 5 minutes. For pregnant women, the dosage is different. They dissolve from 75g to 100g of glucose. For children, dissolve 1.75g / kg of body weight in water, but not more than 75g.
Asthmatics or those who have angina, had a stroke or heart attack are advised to consume 20g.
Glucose for the glucose tolerance test is sold in pharmacies in powder form.
It is impossible to produce a carbohydrate load on your own!
Be sure to consult with your doctor before making any hasty conclusions and conducting unauthorized GTT with a load at home!
With self-control, it is best to take blood in the morning on an empty stomach, after each meal (not earlier than 30 minutes later) and before bedtime.
3. Repeated blood sampling
At this stage, several blood samples are taken. In 60 minutes, they will take blood for analysis several times, and check fluctuations in blood glucose, on the basis of which it will be possible to draw some conclusions.
If you know at least approximately how carbohydrates are digested (i.e., you know how carbohydrate metabolism occurs), then it will be easy to guess that the faster glucose is consumed, the better our pancreas works. If the "sugar curve" stays at the peak for quite a long time and practically does not decrease, then we can already talk about at least.
Even if the result turned out to be positive, and you have already been diagnosed with diabetes, this is not a reason to get upset ahead of time.
In fact, the glucose tolerance test always requires rechecking! Call it very accurate - it is impossible.
The attending physician will prescribe a second test, who, based on the testimony received, will already be able to somehow advise the patient. It is not uncommon that the analysis had to be taken from one to three times if no other laboratory methods were used for diagnosing type 2 diabetes mellitus or it was influenced by some factors described earlier in the article (medication, blood donation did not occur on an empty stomach and etc.).
Test results, normal for diabetes and pregnancy
methods for testing blood and its components
Let's say right away that the reconciliation of the testimony must be done taking into account what kind of blood was analyzed during the test.
It can be considered as whole capillary blood and venous. However, the results do not differ to such a large extent. So for example, if we look at the result of a whole blood test, then they will be somewhat less than those obtained in the process of testing blood components obtained from a vein (for plasma).
With whole blood, everything is clear: they pricked a finger with a needle, took a drop of blood for biochemical analysis. Not much blood is required for these purposes.
With a venous one, it’s a little different: the first blood sampling from a vein is placed in a cold test tube (it’s better, of course, to use a vacuum tube, then you won’t need extra manipulations with blood preservation), which contains special preservatives that allow you to save the sample until the test itself. This is a very important stage, since unnecessary components should not be mixed with the blood.
Several preservatives are usually used:
- sodium fluoride at the rate of 6 mg/ml whole blood
It slows down enzymatic processes in the blood, and at this dosage it practically stops them. Why is it necessary? First, the blood is not in vain placed in a cold test tube. If you have already read our article on glycated hemoglobin, then you know that under the influence of heat, hemoglobin is “sugared”, provided that the blood contains a large amount of sugar for a long time.
Moreover, under the influence of heat and with the actual access of oxygen, the blood begins to “spoil” faster. It oxidizes, becomes more toxic. To prevent this, in addition to sodium fluoride, one more ingredient is added to the test tube.
- sodium citrate (or EDTA)
It prevents blood clotting.
Then the test tube is placed on ice, and special equipment is prepared to separate the blood into components. Plasma is needed, to get it they use a centrifuge and, pardon the tautology, centrifuge the blood. The plasma is placed in another test tube and its direct analysis is already beginning.
All these machinations must be carried out quickly and within a thirty-minute interval. If the plasma is separated after this time, then the test can be considered a failure.
- glucose-oxidase method (norm 3.1 - 5.2 mmol / liter);
To put it quite simply and roughly, then it is based on enzymatic oxidation with glucose oxidase, when hydrogen peroxide is formed at the output. Previously colorless orthotolidine, under the action of peroxidase, acquires a bluish tint. The amount of pigmented (colored) particles “says” about the concentration of glucose. The more of them - the higher the level of glucose.
- orthotoluidine method (norm 3.3 - 5.5 mmol / liter)
If in the first case there is an oxidative process based on an enzymatic reaction, then here the action takes place in an already acidic environment and the intensity of staining occurs under the action of an aromatic substance derived from ammonia (this is orthotoluidine). A specific organic reaction occurs, as a result of which glucose aldehydes are oxidized. The amount of glucose is indicated by the color saturation of the "substance" of the resulting solution.
The orthotoluidine method is considered more accurate, respectively, it is most often used in the process of analyzing blood for GTT.
In general, there are quite a few ways to determine glycemia that are used for tests, and they all fall into several large categories: colorimetric (the second method we have considered); enzymatic (the first method considered by us); reductometric; electrochemical; test strips (used in glucometers and other portable analyzers); mixed.
the norm of glucose in healthy people and in diabetes mellitus
We will immediately divide the normalized indicators into two subsections: the norm of venous blood (plasma analysis) and the norm of whole capillary blood taken from a finger.
venous blood 2 hours after a carbohydrate load
whole blood
If we are talking about the norm of glucose in healthy people, then with fasting rates of more than 5.5 mmol / liter of blood, then we can talk about prediabetes and other disorders resulting from a violation carbohydrate metabolism.
In this situation (of course, if the diagnosis is confirmed), it is recommended to reconsider all your eating habits. It is advisable to reduce the consumption of sugary foods, bakery products and all confectionery. Exclude alcoholic drinks. Don't drink beer and eat more vegetables (preferably raw).
The endocrinologist can also refer the patient for a complete blood count and ultrasound of the organs. endocrine system person.
If we are talking about those already suffering from diabetes, then their indicators can vary significantly. The trend, as a rule, is directed towards increasing the final results, especially if some have already been diagnosed. This test is used in the interim evaluation testing of progression or regression of treatment. If the indicators are significantly higher than the initial ones (obtained at the very beginning of the diagnosis), then we can say that the treatment does not help. It does not give the desired result and, quite possibly, the attending physician will prescribe a number of drugs that forcibly reduce sugar levels.
We do not recommend buying prescription drugs right away. It is best, again, to reduce the amount of bread products (or completely abandon them), completely eliminate all sweets (do not even use sweeteners) and sugary drinks (including diet "sweets" on fructose and other sugar substitutes), increase physical activity (with At the same time, carefully monitor glycemic values before, during and after training: see). In other words, direct all efforts to its further complications and focus exclusively on a healthy lifestyle.
If someone says that they are unable to give up sweet, starchy, fatty, do not want to move and sweat in the gym, burning excess fat, then they do not want to be healthy.
Diabetes does not make any compromises with humanity. Do you want to be healthy? Then be it right now! Otherwise, diabetic complications will eat you up from the inside!
norm of glucose tolerance testing during pregnancy
In pregnant women, things are a little different, because in the process of bearing a child, the body of women is subjected to severe "stress", which consumes a huge supply of maternal reserves. They should definitely follow a diet rich in vitamins, trace elements and minerals, which the doctor should prescribe. But even this, sometimes, is not enough and you should replenish with balanced vitamin complexes.
Due to some confusion, pregnant women often go too far and begin to consume a much larger set of products than is required for the healthy development of the baby. This is especially true of carbohydrates contained in a particular food set. This can have a very detrimental effect on the energy balance of a woman and, of course, affect the baby.
If observed, then they can make a preliminary diagnosis - (GDM), in which the level of glycated hemoglobin can also be increased.
So, under what circumstances is this diagnosis made?
If we are talking about indicators above 7.0 mmol / liter, then it is quite possible that the level of “sweet” hemoglobin will be in the region of ≥6.5% of the total amount of all hemoglobin contained in the analyzed blood. This directly indicates that the pregnant woman has excess weight, which is not typical for pregnant women at one time or another.
It is best for women who have previously shown signs of impaired carbohydrate metabolism to take an oral glucose tolerance test between 24 and 26 weeks of actual pregnancy. Thus, it is possible to prevent the development of irreversible consequences in time, which will be dangerous not only for the life of the child, but also for future mother. With GDM, childbirth is complicated, there is a high chance of getting postpartum injuries, and also with serious fears for the life of the baby and the woman (if the child grows very large), they can resort to intentional premature birth. You understand that a child, despite its large size and weight, may be premature. It will have to be nursed under the close supervision of specialists in special conditions designed for the artificial "carrying out" of the child.
Characteristics of the analysis
Type of analysis |
biochemical |
Name | glucose tolerance test, GTT |
What is being researched |
whole blood or its components (plasma) |
Training |
Children under 14 years of age are not allowed to take this test! |
Indications |
|
Unit of measure for glucose |
mmol/liter |
Deadline |
laboratory analysis within 1 day |
Norm of a healthy person |
3.5 - 5.5 |
Which doctor prescribes |
|
What is the price |
|
What causes a false positive | Many thanks to everyone who does not remain indifferent and shared the record! |
Diagnosis of the body on - a special laboratory method for determining diabetes mellitus (DM) and its previous condition. There are two types:
- intravenous test using glucose;
- oral glucose tolerance study.
The analysis shows how the human body dissolves glucose in the blood. The nuances, methods of conducting and the feasibility of a glucose tolerance test will be discussed below. You will find out what is the norm of this study and its pitfalls.
Glucose is a monosaccharide used by the body to maintain vital energy. If a person has diabetes who has never been treated, there is a large amount of a substance in the blood. The test is needed for the timely diagnosis of the disease and the start of treatment at an early stage. How the tolerance test is carried out is described below.
If the analysis shows a high level, the person has type 2 diabetes. Pregnant women should not be afraid, because with an "interesting position" the concentration of sugar in the blood rises.
Carrying out a test for glucose tolerance is a simple procedure that should be carried out regularly as a preventive measure.
Why take the test and who is prescribed the test
The value of the study is difficult to overestimate. The analysis reveals the feasibility of carrying out other manipulations necessary for the diagnosis of diabetes mellitus. Particular attention is paid to pregnant women, as well as people prone to diabetes. Do a test for safety and health.
Test preparation
The analysis is preceded by careful preparation. Before the first test for glucose tolerance, doctors recommend that you follow a diet: exclude fatty, spicy foods and foods high in carbohydrates from the diet. Eat 4-5 times a day (breakfast, lunch, dinner and 1-2 snacks) without overeating and fasting - the saturation of the body with useful substances for normal life should be complete.
How do I get tested for glucose tolerance? Only on an empty stomach: for 8 hours, exclude the use of food. But you should not overdo it: fasting is allowed no more than 14 hours.
The day before the test for glucose tolerance completely give up alcohol and cigarettes.
Before you start preparing for the study, consult with your doctor about taking medications. The test will be inaccurate when taking pills that affect blood sugar. These include medicines that contain:
- caffeine;
- adrenalin;
- glucocorticoid substances;
- thiazide diuretics, etc.
How is a glucose tolerance test done?
How to take a glucose tolerance test - the doctor who will perform the procedure will explain. Let's talk briefly about the features of the test. First, consider the specifics of the oral method.
A blood sample is taken for analysis. The patient drinks water containing a certain amount of glucose (75 grams). Then the doctor takes a blood sample for analysis every half an hour or an hour. The procedure takes about 3 hours.
The second method is rarely used. It is called the intravenous blood sugar test. Its peculiarity lies in the ban on the use for diagnosing diabetes. A blood test by this method is performed as follows: the substance is injected into the patient's vein for three minutes, after determining the level of insulin.
Having made an injection, the doctor makes a count at the 1st and 3rd minutes after the injection. The measurement time depends on the point of view of the doctor and the method of the procedure.
Feelings during the test
When performing a glucose tolerance test, discomfort is not ruled out. Don't worry, this is the norm. The study is characterized by:
- increased sweating;
- dyspnea;
- slight nausea;
- fainting or fainting state.
As practice shows, the glucose tolerance test causes side effects quite rare. Before passing the analysis, calm down and do auto-training. Nervous system stabilized and the procedure went without complications.
What is the norm of the glucose tolerance test
Before the study, read the rules of analysis in order to approximately understand the results. The unit of measure is milligrams (mg) or deciliters (dl).
Norm at 75 gr. substances:
- 60-100 mg - initial result;
- 200 mg after 1 hour;
- up to 140 mg in a couple of hours.
Keep in mind that units of measurement for measuring blood sugar levels vary by lab - check with your doctor for this information.
The test sometimes shows not at all rosy results. Don't be discouraged if the numbers don't match. You need to find out the cause and solve the problem.
If blood sugar exceeds 200 mg (dm) - the patient has diabetes.
The diagnosis is made exclusively by a doctor: a high sugar level is possible with other diseases (Cushing's syndrome, etc.).
The importance of analysis is difficult to overestimate. A person's well-being depends on the level of glucose, this indicator must be kept under control. If you want to enjoy life and be constantly active, you should not ignore blood sugar.
With normal metabolism in the urine, ketone bodies are not detected, since the body extracts the glucose it needs from the incoming food. Also, a person receives this carbohydrate during the breakdown of glycogen - a substance that is stored and stored in the liver. With pathological processes and a lack of glucose, the body has to extract it from the fat depot. As a result of the destruction of fat cells, a large amount of acetone products is released into the blood. After passing through the renal tubules, these substances are in the urine. The appearance of ketone bodies in the urine often becomes a consequence of a violation of metabolic processes - namely, carbohydrate and fat metabolism.
The reasons for the increase in the level of these substances in the secretions of the patient are as follows:
- Pregnancy - in this case, the formation of ketone products is due to toxicosis. If the developing fetus experiences a lack of glucose, then the mother's body can sacrifice fat reserves in order to provide the nutrients the unborn child needs.
- Malignant tumors of the hematopoietic organs - with leukemia and leukemia, a huge amount of energy is expended. The disease progresses rapidly and weakens the patient's body.
- Diabetes mellitus - in such patients, an increase in ketones in the urine often indicates the severity of the disease. If the indicators of these substances increase to ten mmol, signs of hyperglycemic coma may soon appear.
- Neoplasms of the thyroid and adrenal glands endocrine glands leads to hormonal imbalance. At the same time, ketone substances begin to appear in urine due to the acceleration of fat metabolism in the body, which is a consequence of an increase in the amount of corticosteroids in the blood. In the case of the development of thyrotoxicosis in men and women, an excess of glucose is observed.
- Insufficient intake of carbohydrates with food - with weight loss, abuse of protein foods, fasting and dietary nutrition, ketone bodies can also be detected in the urine test.
- Liver pathologies - cause a violation of the functioning of this organ (chronic alcoholism).
- Inflammatory and tumor processes of the gastrointestinal tract - lead to an increase in ketone bodies in the urine due to a lack of nutrients. In such situations, the absorption of carbohydrates, proteins and fats is disrupted.
- Bacterial and viral infections- such diseases often occur with high temperature, which requires large energy costs.
- Severe intoxication - in this situation, traces of ketones in the urine indicate poisoning with heavy metals or atropine.
In the normal state, glucose consumption can increase dramatically in case of hypothermia, during heavy physical labor. But its daily rates usually range from 5 mg to 15 mg. With such a low amount of acetone, no changes in the well-being of a person are noted.
test strips
Sugar level
Indicator test strips Bioscan Ketones are strips of white non-toxic plastic coated with indicator elements (a set of reagents). The color of the sensor is white with a dull beige tint.
All components of the Bioscan Ketone indicator test strips are non-toxic.
The lid of the test strip container contains a desiccant to protect the test strips from exposure to air and moisture during storage.
Qualitative determination of Ketones by the Bioscan test strip consists in registering the fact of sensor staining, which confirms the presence of ketones in the test urine sample. A semi-quantitative determination is carried out when deciphering the results, it consists in establishing specific amounts of ketone bodies in the urine by extrapolating (comparing) the color of the test strip indicator with a color scale (table) printed on the Bioscan Ketones tube.
The color scale (table) for ketones for deciphering the results of the analysis consists of five color fields, above each of which the corresponding concentration of ketones corresponding to the concentrations of acetoacetic acid is indicated.
The range of detectable concentrations of ketones in urine (as acetoacetic acid) is from 0.5 to 10 mmol/l (5-100 mg/100 ml).
The functioning of the indicator element of the visual test strips Bioscan Ketones is based on the reaction of acetone (ketone bodies) with sodium nitroprusside in an alkaline medium (Legal's test) (Legal's reaction). As a result of this reaction, the indicator element of the test strip turns purple, the saturation of which increases with an increase in the content of ketones (acetone) in the urine.
Indicator test strips Bioscan Ketones are more sensitive to acetoacetic acid than to acetone, which is a decomposition product of acetoacetic acid. The practical sensitivity limit of test strips for acetoacetic acid is 0.5 mmol / l (5 mg / 100 ml), for acetone - 10 mmol / l (57 mg / 100 ml).
Drugs containing phenyl ketones and phthalein compounds color the indicator element in red tones, which, however, are clearly different from the purple color characteristic of ketones. If in doubt, it is necessary to repeat the analysis after the end of drug therapy.
Interpretation of test results obtained using Bioscan visual test strips can be difficult when examining cloudy, significantly stained urine samples.
The effect of individual drugs, as well as other metabolites, on the results of the analysis is not always predictable. The results of the analysis, which do not correspond to the disease or seem doubtful, should be checked by other diagnostic methods. Urinary acetone (ketones) testing should be repeated after completion of drug therapy.
Bioscan test strips, according to the "Nomenclature classification of medical devices by classes, depending on the potential risk of their use", belong to class 2a (medical devices with an average degree of risk).
According to the "All-Russian Classifier of Economic Activities, Products and Services" (OKDP), visual test strips Bioscan Ketones were assigned the code 2429422 - "Complex diagnostic reagents". Companies involved in the sale of test strips are assigned the OKVED statistics code 51.46.1 (Wholesale trade in pharmaceutical and medical goods).
An alternative to the indicator test strips Bioscan Ketones is a general urine test.
Urinalysis (OAM, clinical urinalysis) is a set of laboratory tests of urine conducted for diagnostic purposes. The advantage of a general urine test over Bioscan test strips is not only the assessment of the biochemical and physicochemical properties of urine, but also sediment microscopy (using a microscope).
When conducting a general analysis, as a rule, daily urine is used.
Daily urine is all the urine excreted from the body during the day (24 hours). Daily urine, in contrast to the one-time morning urine used in diagnostics with Bioscan indicator test strips, is a more informative material for research.
Self-diagnosis with test strips, even if all instructions are followed, is not a substitute for regular health assessment by a qualified medical specialist, doctor.
Qualitative determination of the test strip
In order for the result of the analysis to be the most accurate, you need to correctly collect urine. To do this, you need to take a clean container, without contamination.
The collected urine for research must be delivered within a day, otherwise the acetone will begin to break down. Keeping the urine container in the refrigerator extends this period to 2-3 days.
However, all this applies to the traditional methods used so far, based on the use of a special liquid or dry reagent based on sodium nitroprusside. Such methods include the test of Lange, Legal, Lestrade. The presence of acetone in the urine is determined according to the change in the color of the medium.
Test strips are applicable in the following cases:
- for the rapid diagnosis of acetonuria (when the release of ketone bodies increases during urination);
- control over the process of weight loss;
- choice of diet;
- early detection of diabetic ketoacidosis (in case of diagnosing diabetes mellitus).
When interacting with a low-alkaline medium, a change in color indicators occurs on the test strip. This is what makes it possible to find out the level of acetone in the urine.
After the technique is carried out, a color tint appears on the strip, characteristic of a certain ketone concentration in the body. You can measure the level of acetone by comparing the result with the example on the package.
Test strips can be found with two sensors: to detect the amount of glucose and ketone bodies.
The qualitative determination of ketones in urine with a test strip is based on the registration of the fact of indicator staining, which means the presence of ketone bodies in this test sample.
However, do not forget that the price depends on many parameters: this is the manufacturer, the number of measured parameters, the number of strips in the package, and the scope (for example, the most expensive strips - Aution Sticks - can also be used in automatic urine analyzers).
Ketones, ketone bodies, acetone, KET, “ket” are synonymous terms that refer to a group of toxic metabolic products, which includes beta-hydroxybutyric, acetoacetic acid, and acetone, formed in the liver from coenzyme “A”. Ketones are synthesized during the formation or breakdown of fats. Under normal conditions in a healthy person, ketones are formed in extremely insignificant amounts, undergo rapid deactivation and, without causing harm, are excreted from the body in the urine or exhaled air.
^6,-hydroxybutyric acid is an intermediate product of fatty acid oxidation in the body, related to acetone (ketone) bodies. In peripheral tissues, beta-hydroxybutyric acid is oxidized to acetoacetic acid.
Acetoacetic acid is a colorless mobile oily liquid involved in metabolism. Acetoacetic acid is extremely unstable: even with slight heating (in aqueous solution) it decomposes into acetone and carbon dioxide.
Acetone - organic matter, which is natural, the simplest representative of saturated ketones. Acetone is always present in the blood of a healthy person, its content does not exceed 1-2 mg / 100 ml, in daily urine - no more than 0.01-0.03 grams (these volumes are not detected by standard laboratory tests during general (clinical) ) analysis, or indicator test strips at home). Metabolic disorders (most often in diabetes mellitus) leads to excessive formation and excretion of acetone.
With an increase in the rate of fat metabolism in the body, the process of formation of ketones accelerates, the liver does not have time to completely deactivate them, acidification of the blood (ketoacidosis) begins, and acetone is detected in the urine.
Acetone in the urine is not a disease or a clinical symptom of the disease. “Acetone in urine” is a laboratory term that means a positive reaction when testing for the presence of ketones in the urine with test strips.
An increased content of ketones in the urine is accompanied by the following conditions:
- chronic vomiting,
- fever,
- digestive disorders,
- hunger.
Ketones in the urine, in most cases, are observed in children and pregnant women. The reasons for its appearance in these groups are largely different, but they are connected by a common reason - not proper nutrition(if ketonuria does not occur against the background of diabetes mellitus). Acetone in the urine in children is usually a symptom of uric acid diathesis.
Uric acid diathesis in children (nervous-arthritic diathesis) is the state of the child's body against the background of metabolic disorders. Uric acid diathesis in children is caused by hereditary (genetic) factors, usually accompanied by increased emotional and nervous excitability, eating disorders, a tendency to ketoacidosis (increased concentration of ketone bodies in the blood).
Ketones in the urine of children appear under the following circumstances:
- glycogenosis types 1, 3 and 4,
- child dehydration,
- de Toni-Debre-Fanconi syndrome (congenital rickets-like disease, manifested by lesions of the proximal renal tubules, accompanied by lethargy, chronic malnutrition and digestion, loss of appetite, dehydration),
- the predominance of fatty foods in the diet (with a deficiency of carbohydrates),
- non-diabetic ketoacidosis,
- thyrotoxicosis (due to excessive production of hormones thyroid gland arising from diseases of the pituitary or thyroid gland).
Ketones in the urine of a pregnant woman may be the result of metabolic and metabolic failures (if ketonuria is not associated with diabetes mellitus).
Price Bioscan Ketones
The price of visual indicator test strips Bioscan Ketones for the determination of ketones (acetone) in urine does not include shipping costs if the strips are purchased through an online pharmacy. Prices can vary significantly depending on the place of purchase.
Estimated cost of Bioscan Ketones:
- Russia (Moscow, St. Petersburg) from 185 to 225 Russian rubles,
- Ukraine (Kyiv, Kharkov) from 61 to 74 Ukrainian hryvnias,
- Kazakhstan (Almaty, Temirtau) from 871 to 1060 Kazakhstani tenge,
- Belarus (Minsk, Gomel) from 48655 to 59175 Belarusian rubles,
- Moldova (Chisinau) from 52 to 63 MDL,
- Kyrgyzstan (Bishkek, Osh) from 202 to 245 Kyrgyz soms,
- Uzbekistan (Tashkent, Samarkand) from 7174 to 8726 Uzbek soums,
- Azerbaijan (Baku, Ganja) from 2.8 to 3.4 Azerbaijani manats,
- Armenia (Yerevan, Gyumri) from 1271 to 1546 Armenian drams,
- Georgia (Tbilisi, Batumi) from 6.3 to 7.7 Georgian lari,
- Tajikistan (Dushanbe, Khujand) from 17.4 to 21.2 Tajik somoni,
- Turkmenistan (Ashgabat, Turkmenabat) from 8.9 to 10.9 new Turkmen manats.
Dry reagent preparation
sodium nitroprusside 1 g, ammonium sulfate 20 g, anhydrous sodium carbonate 20 g. Weighed reagents are carefully ground in a mortar until a fine homogeneous powder is obtained. The powder is stored in a well-corked glass jar in a dry place.
Research progress:
The glass slide is placed on a sheet of filter paper. A small amount (at the tip of a knife) of a dry reagent or a tablet is placed on the glass and 2-3 drops of urine are applied to it.
Interpretation of the results obtained:
In the presence of ketone bodies, a pink to dark purple color is obtained (the appearance of color can occur within 2-3 minutes).
Laboratory tests and home tests
The first time ketones in the urine are detected in the laboratory, test strips can be purchased at the pharmacy for further control at home.
In the form of laboratory analysis, ketones are designated ket, but on the contrary, their absence or presence, and concentration are indicated. Normally, ketone bodies should not be detected in the urine. And the presence of acetone is indicated by "+", mmol / l, or mg / dl.
- + weakly positive result, traces of ketone bodies are present in the urine. Their concentration is less than 20 mg/dL. With such indicators, treatment is carried out at home.
- + and ++ positive result, moderate condition. The concentration is about 35 mg/dL. Treatment can be carried out at home, but always under the supervision of a doctor. If you feel unwell, go to the hospital.
- +++ sharply positive result. The number of ketone bodies is 10 mmol / l, or more than 80 mg / dl. And this poses a threat to life and requires the immediate intervention of doctors in a hospital.
The determination of ketone bodies in the urine at home occurs using test strips. The principle of their action: when acetone enters, the strips are colored. The brightness of the color depends on the concentration of ketones.
For the study, urine is collected, then the strips are lowered into it. The degree of staining of the strip is compared with the scale on the package, and the result is deciphered.
Even if ketone bodies have been detected once, it is better to purchase test strips and use them at the slightest suspicion. Most often, this condition occurs in children under 12 years of age and pregnant women, and is associated with malnutrition. In this case, it is enough to replenish the fluid in the body, and a diet that restores the carbohydrate balance. Electrolyte solutions are used to remove acetone. You need to drink them in small portions every ten minutes. If such a condition occurs in a pregnant woman in the second half of pregnancy, then it may indicate a formidable complication - preeclampsia, or the presence of diseases. Additional tests and medical supervision will be required.
Acetonuria is a condition that requires control and adequate treatment. And to be sure that it is not associated with serious diseases, you must definitely visit a specialist and undergo a series of examinations.
Instruction
Before using indicators to diagnose changes in the level of ketone bodies in the urine, it is important to read the instructions that come with the test tube. This is necessary, since each manufacturer specifies a different exposure time for indicators in biological material.
Step-by-step instructions for using indicator strips:
- Collect urine in a prepared container (5 ml is enough). For the test, use fresh urine or a shelf life that does not exceed 2 hours. In this case, it is necessary to observe the storage conditions - in a dark place at room temperature. For the accuracy of the results, it is recommended to use an average portion of morning urine for diagnosis.
- Stir the collected biological material.
- Remove the strip, then close the tube tightly.
- Dip the test into the urine so that the indicator is completely submerged.
- Hold for 5 seconds or more if directed by the manufacturer.
- Remove the strip, attach the edge to the paper to remove excess moisture.
- For a chemical reaction, put on a flat surface with the indicator up.
- Compare the color of the express test with the scale printed on the tube to check the level of ketones in urine.
It should be noted that if the storage conditions of the strips are not observed, the use of stale urine, as well as at air temperatures below 15C and more than 30C, the analysis may be unreliable. Also distort the results of taking medications and some foods that can stain urine, such as beets, paprika. During menstruation, a ketone test is not performed.
Analogues Bioscan Ketones
Analogues (synonyms) of visual indicator test strips Bioscan Ketones for the determination of ketones (acetone) in urine are the following medical products.
Analog Bioscan Ketones with a single indicator:
- Ketofan test strips (Ketofan No. 50, KetoPhan) - European test strips from Erb Lahem, Czech Republic (formerly part of the pharmaceutical holding Teva, Israel),
- Uriket-1 test strips (Uriket-1 No. 50) - Russian analogue from Biosensor AN, the most popular products for detecting ketonuria in the medical market of Russia, Belarus and Kazakhstan,
- Ketourichrome (Ketourichrome No. 25/No. 50) are the first Russian strips for measuring ketones in urine. Currently unavailable for order.
Analog Bioscan Ketones with two indicators:
- Test strips Ketogluk-1 (Ketogluk-1 No. 50) - strips from the Russian company Biosensor AN, allowing for research on two parameters (acetone and glucose in urine),
- Diafan - strips with two indicators for determining the level of sugar and acetone from Erb Lahem, Czech Republic.
Multifunctional analogues of Bioscan Ketones:
- Bioscan Penta (Bioscan Penta No. 50 / No. 100) strips with five indicators from the Bioscan company, allowing you to conduct urine tests not only for acetone, but also for glucose, occult blood (erythrocytes and hemoglobin), total protein (s), acidity (pH ),
- Uripolian - strips from Biosensor AN with ten indicators, allowing you to analyze urine according to the following characteristics - glucose (sugar), ketone bodies (acetone), occult blood (erythrocytes, hemoglobin), bilirubin, urobilinogen, density ( specific gravity), ascorbic acid, leukocytes, total protein (albumins and globulins) and acidity (pH),
- Pentafan test strips / Pentafan Laura for ketone bodies, occult blood, glucose, total protein and urine pH (acidity) from Erb Lahem, Czech Republic.
The prices of multifunctional analogues are significantly higher, since the Bioscan Ketone test strips are intended for analysis exclusively for ketonuria.
Determination of ketone bodies in urine
Ketone bodies include acetone, acetoacetic and β-hydroxybutyric acids.
Normally, 20–50 mg of ketone bodies are excreted in the urine per day. Ketone bodies appear in the urine before there is a significant increase in their concentration in the blood.
To determine ketone bodies use:
- unified Lange test;
- Rothera's test;
- ready-made kits for express analysis of acetone in urine produced by various domestic and foreign companies.
Standardized Lange test
The principle of the method. Sodium nitroprusside in an alkaline medium reacts with ketone bodies to form a red-violet complex.
Reagents. 1) 5% solution of sodium nitroprusside (Na 2 × 2H 2 O) is prepared before use; 2) concentrated acetic acid; 3) 25% ammonia solution (NH 4 OH).
Definition progress
3–5 ml of urine is poured into a test tube, 5–10 drops of sodium nitroprusside and 0.5 ml of acetic acid are added, mixed and 2–3 ml of ammonia are layered carefully with a pipette along the wall of the test tube
Evaluation of the result. Within 3 minutes, a red-violet ring is formed at the interface of the media - the test is positive.
Modified Rothera sample
The principle is the same as in the Lange test.
Reagents. 1) 5% solution of sodium nitroprusside - (Na 2 × 2H 2 O) is prepared before use; 2) ammonium sulfate (NH 4) 2 SO 4 (dry); 3) 25% ammonia solution (NH 4 OH).
Definition progress
Approximately 0.2 g of dry ammonium sulfate, 5 drops of urine and 2 drops of sodium nitroprusside solution are thoroughly mixed in a test tube, and then 10-15 drops of 25% NH4OH solution are carefully layered onto the mixture. In the presence of ketone bodies in the urine, a red-violet ring is formed at the interface between the media, the color intensity of which makes it possible to roughly judge their concentration (see
table "Tentative quantitative assessment of ketone bodies in urine").
Approximate quantification of ketone bodies in urine
Note. At a low concentration of ketone bodies, a pale-colored ring may appear after 8-10 minutes.
clinical significance. Most often, ketonuria is observed in diabetes mellitus. It is a criterion for the correct selection of the diet: if the amount of fats administered does not correspond to the amount of digestible carbohydrates, then the release of ketone bodies increases.
Other causes of ketonuria may be acute febrile conditions; toxic conditions (vomiting, diarrhea), gastrointestinal disorders, the effects of anemia, constipation, prolonged exposure to cold, heavy physical exertion.
Children are especially prone to developing ketonuria and ketosis. Ketone bodies appear in the urine before there is a significant increase in their concentration in the blood.
Research results
With a mild stage of acetonuria, the ketone level is 0.5 - 1.5 mmol / l, for moderate and severe degrees, these figures are 4 and 10, respectively.
When buying these funds at a pharmacy, it is worth informing the pharmacist for what purpose this purchase is being made. The ideal option is to provide packaging from previous test strips.
After receiving the morning portion of urine, you should proceed to the following procedures:
- Open the box, take the strip by the edge, on which there is no applied indicator.
- After removing the strip, you must immediately close the box so that the remaining tests are not exposed to sunlight.
- If it is necessary to lay the strip, then this should be done on a flat surface and only with the indicator part up.
- The results of the analysis can be checked after a few minutes, if the evaluation is carried out earlier, the result of the analysis may be uninformative or even unreliable.
- After changing the color of the indicator, the final result is evaluated.
Today, there are many manufacturers of these tools, each of which provides its own result evaluation table. To carry out the analysis, you do not need to have any knowledge, the result of the assessment can be carried out independently at home.
If the implementation of this analysis was followed with all the recommendations described above, then the result should be checked against the table that should be on the tube of the test strip. Below is an image of an approximate assessment of the presence of acetone in the urine.
Thanks to the express method, you can find out not only the presence of ketone bodies, but also the degree of their increase.
If the amount of acetone in the urine is normal, then the strip in this case has no color. The result will be negative when the number of ketone bodies is less than 0.5 mmol / l.
A slight increase in ketone bodies will show a light pink color. This condition is designated as one plus, and this indicates a mild degree of ketonuria. This does not pose a danger to the life of the patient, but requires treatment.
If the presence of ketone bodies is too high, the strip will turn purple. In practice, this condition corresponds to four pluses and indicates the presence of a serious condition - ketoacidosis. It is dangerous to health, treatment takes place exclusively in a hospital.
The glucose tolerance test measures how the body metabolizes carbohydrates from food. To do this, the patient takes a solution of glucose, and then its content in the blood is measured. The analysis helps to identify the latent form of diabetes and the likelihood of its development in the future. Learn more about the rules for preparing and donating blood, as well as how to normalize indicators, from this article.
📌 Read this article
When to Test Glucose Tolerance
A feature of the course of type 2 diabetes mellitus is a rather long latent period. At this time, there is already tissue resistance to the produced insulin, but there are no classical signs (thirst, copious urine output, severe weakness, bouts of hunger) yet.
To determine carbohydrate metabolism disorders, a conventional blood glucose test is not enough, as it often shows the norm.
The first group of people who need a glucose tolerance test are patients with non-specific symptoms, they can also be with diabetes:
- pustular rash on the skin, recurrent furunculosis, skin itching;
- impaired visual acuity, flashing dots before the eyes;
- thrush, itching in the perineum;
- increased fatigue, drowsiness, aggravated after eating;
- sexual dysfunctions - impotence, failure of the menstrual cycle, decreased libido, infertility;
- fragility of hair and nails, baldness, dry skin, prolonged wound healing;
- tingling and numbness of the extremities, nocturnal muscle twitches;
- sweating, cold hands and feet;
- obesity with a predominant deposition of fat around the waist;
- bleeding gums, loosening of teeth.
The second group includes patients at risk of developing diabetes mellitus with or without symptoms. These include:
- over 45 years of age;
- having diabetics in the family (among blood relatives);
- patients with dyscirculatory encephalopathy, peripheral, polycystic ovaries;
- suffering from overweight body (body mass index above 27 kg/m2), metabolic syndrome;
- leading an inactive lifestyle, smoking, abusing alcohol;
- eating sweets, fatty foods, fast food;
- upon detection of high levels of cholesterol in the blood, uric acid (gout), insulin, accelerated platelet aggregation;
- people with chronic diseases kidneys, liver;
- patients with periodontal disease, furunculosis;
- taking hormonal drugs.
For a risk group for diabetes, the analysis should be taken at least once a year; to exclude errors, it is recommended to conduct it twice with an interval of 10 days. For diseases digestive system or in doubtful cases, glucose is not administered orally (in a drink), but intravenously.
Contraindications for analysis
Since this examination is a burden on the body, it is not recommended in such situations:
- acute inflammatory process (may lead to progression, suppuration);
- peptic ulcer, impaired absorption of food or motor function of the digestive system due to gastric resection;
- signs of an "acute abdomen", the need for an urgent operation;
- a serious condition with, stroke, cerebral edema or;
- violation or acid balance of the blood;
- diseases of the adrenal glands, thyroid gland, pituitary gland with an increase in blood glucose;
- the use of hormones, contraceptives, beta-blockers, anticonvulsants;
- menstruation, childbirth;
- cirrhosis of the liver;
- vomiting, diarrhea.
Some of these conditions can be corrected and then an oral glucose tolerance test can be performed. If you have been diagnosed with diabetes mellitus or if you have high fasting blood sugar due to other reasons, the test does not make sense.
Expert opinion
Alena Ariko
Expert in cardiology
It should be borne in mind that stress hormones have a great influence on the content of glucose in the blood. Therefore, severe experiences, unrest, surgery, trauma, and past illnesses often become the cause of the detected violations.
Such a result is considered as a false positive, but it means that the patient still has a tendency to disturb carbohydrate metabolism. Such people without fail need lifestyle changes and proper nutrition to prevent diabetes.
Why do during pregnancy
During the period of bearing a child, even in a healthy woman, against the background of hormonal changes, the metabolism of carbohydrates can be disturbed. The main symptom of gestational diabetes is an increase in blood glucose after a meal., and on an empty stomach the indicator can be completely within the normal range.
Glucose tolerance during pregnancy is examined if:
- the previous proceeded with gestational diabetes;
- the weight of the child at birth exceeded 4.5 kg;
- there were stillbirths, miscarriages, premature births, polyhydramnios;
- mother's age under 18 or over 30;
- developmental anomalies were found in the newborn;
- before pregnancy had polycystic ovaries;
- there is obesity;
- a woman smokes, uses alcohol, drugs.
The first signs of diabetes in pregnant women appear from the second or third trimester and last until childbirth, and then the indicators return to normal. Violation of carbohydrate metabolism is extremely dangerous, as it is a risk factor for improper organ formation.
The fetal pancreas, in response to increased maternal blood sugar, actively produces its own insulin, so children are born with hypoglycemia, which leads to severe neurological disorders.
How to take an oral test
Performing glucose tolerance tests
During the diagnosis, the patient takes blood for glucose several times. Initially, this is the initial level on an empty stomach. Then, with the expanded (full) version of the test, every half an hour for 2 hours after the load. For a standard study, only baseline values and after 2 hours are recorded.
As a carbohydrate solution, 75 g of glucose in a glass of water is used. It should be drunk within 3-5 minutes. This test simulates eating. In response to the entry of sugar into the blood, insulin is released from the pancreas. Under its influence, glucose from the blood begins to penetrate into the cells, and its concentration decreases. The rate of this decline is assessed by the glucose tolerance test.
Based on the data obtained, a graph of changes is built. An increase in levels after exercise is called the hyperglycemic phase, and a decrease is called the hypoglycemic phase. The speed of these changes is characterized by corresponding indices.
Watch the video on the glucose tolerance test:
Glucose tolerance test
- on an empty stomach - 4.1 - 5.8;
- 30 minutes after exercise - 6.1 - 9.4;
- an hour later - 6.7 - 9.4;
- after 1.5 hours - 5.6 - 7.8;
- at the end of the second hour - 4.1 - 6.7.
For pregnant women, glucose tolerance is normal if fasting glycemia is not more than 6.6 mmol / l, and after exercise at any time its level should not exceed 11 mmol / l.
Violation of tolerance
The criteria by which a conclusion is made about a violation of glucose tolerance are as follows:
- fasting sugar is normal (sometimes slightly increased to 6 mmol / l);
- after 2 hours, glycemia in the range from 7.8 to 11.1 mmol / l (higher - diabetes).
This condition is referred to as prediabetes. The pancreas in such patients can produce enough insulin, but the cells' receptors lose sensitivity to it (insulin resistance). Because of this, for a long time after a meal, blood glucose remains elevated.
Sugar curves during the glucose tolerance test
Even in the absence of signs of diabetes, a high concentration of glucose acts destructively on the vessels, which leads to an earlier and more widespread atherosclerotic change in the arteries, the progression of hypertension, angina pectoris, disorders of cerebral and peripheral circulation.
Impaired glucose tolerance is a transitional state in which two paths of development are possible - recovery to normal or transition to type 2 diabetes.
What to do in case of deviations from the norm
As with diabetes, the most important method of normalizing carbohydrate metabolism is nutrition. None of the drugs can prevent sharp fluctuations in glycemia, a sufficiently high level of molecules damages the vascular wall. That's why Products that cause a sharp rise in sugar are categorically contraindicated:
- products made from white flour;
- grapes, bananas, honey, figs, raisins, dates;
- sugar, sweets, ice cream, sweet curds;
- semolina, peeled rice;
- all ready juices, sauces, carbonated drinks.
Also limit fatty meat, fats, fried and spicy dishes. The source of carbohydrates can be vegetables (potatoes, carrots and beets in limited quantities), unsweetened fruits, berries. Instead of sugar, you can use substitutes, preferably natural ones - fructose, stevia.
The opinion about the safety of ready-made confectionery products for diabetics is erroneous. They are only slightly better than those containing sugar and can be eaten in very small amounts.
To prevent vascular disorders and the transition of prediabetes to the classic form of the disease At least 30 minutes of physical activity a day is required, go for walks, give up smoking and alcohol, normalize body weight.
Impaired glucose tolerance occurs in the latent course of diabetes. Detection requires a glucose tolerance test. It is important to properly prepare for it and take into account all the limitations of the event. Based on the results obtained, it is possible to exclude or confirm insufficient absorption of glucose by cells, a threat in the near future of heart disease, blood vessels, and metabolic pathologies. If deviations are detected, then dietary nutrition and lifestyle correction are recommended.