Glucose Tolerance Test


The oral glucose tolerance test is not used too much these days because the other tests are cheaper and easier to do. For this test, one is required to visit the doctor's office or the lab after fasting for eight hours, usually overnight. How is this test administered?

This is how they do the glucose tolerance test. First the blood glucose is measured. Then one is asked to drink about eight ounces of liquid that has a lot of sugar. The amount of sugar is about 75 grams. Yikes! Don't they know this is bad for us? Well, anything for science, right?

If the results of this glucose tolerance test are over 100 mg/dL but less than 126 mg/dL then one has IFG which is short for impaired fasting glucose. This is different from IGT which is acronym for impaired glucose tolerance. Essentially, the blood sugar level of this is higher than normal but not high enough to call diabetes.

The IGT blood sugar level is between 140 mg/dL and 199 mg/dL two hours after the start of an oral glucose tolerance test (GTT). One who has IGT or IFG may be diagnosed as pre-diabetes. Sometimes this occurs before the development of diabetes but have no fear for some with pre-diabetes do not get diabetes at all. So get cracking with the lifestyle modification of eating healthy and exercising.

Studies have shown that Liraglutide improves glucose control better than rosiglitazone. The Liraglutide showed around 40% patients reached A1c (a different type of test from glucose tolerance test) reading of less than 7% when this phase of the studies was completed. The patients in the first study who had been treated with one oral antidiabetic drug had 50% of the subjects reaching the same goal when treated with Liraglutide.

The second study showed that with the participants who had been treated before with one oral antidiabetic drug, the Liraglutide treatment led to near 65% of the patients reaching the desired target for their glucose level. There's no need for the glucose tolerance test here.

The studies were of the 26 week duration that observed the effect of Liraglutide in diabetes. These examined the result of the different doses of Liraglutide when combined with one oral antidiabetic drug. The patients who were not able to control their glucose level by taking one or two oral antidiabetic drugs were the participants in these studies.

There was also a weight difference from 2 to 4 kg among the participants when treated with Liraglutide as opposed to when they were treated with rosiglitazone and glimepride. In addition, they found that Liraglutide was well tolerated when combined with glimepride and metformin.

The most often reported side effect was nausea. Novo Nordisk was encouraged by these clinical results of improved glucose levels, body weight and hypoglycemia risk so much so that they feel confident they are on track to submit for regulatory approval by the middle of 2008.

Liraglutide is a once daily human alternative of the hormone Gluagon like Peptide 1. Novo Nordisk is developing this compound to treat Type 2 diabetes. It is now on Phase 3. It is believed that this compound stimulates the release of insulin only when the glucose level gets too high, result of which was not from glucose tolerance test, I believe. They also believe that compared to other antidiabetic therapy, this compound results in the loss of weight instead of the weight gain.

The other story tells of the brain's impaired ability to sense glucose. And they say this poses a greater risk for type 2 diabetes. A study on mice revealed findings that the brain's inability to sense glucose can result in Type 2 diabetes. What may bring about the brain's ability to respond properly to glucose is a diet high in fat.

UT Southwestern Medical Center, Harvard Medical School and Oregon Health and Science University researchers were the first to show how some neurons activated by glucose respond to glucose as well as the physiological role of glucose sensing in these neurons.

Scientists discovered these neurons in the 1960's but did not find out the role it played in the development of type 2 diabetes. The new findings will open new research The mechanism in the glucose sensing neurons is related to how the body utilizes fuels. One of these fuels is glucose and it comes from the food we eat.

This is used by the body to make a molecule they call ATP which supplies energy to the cells. This ATP in the brain can make the tiny pores in the glucose-sensing neurons to close so it allows the potassium in and out of the cells. When the ATP closes the potassium channels the neurons that sense glucose are active and they become less active when the ATP levels are low.

The researchers disrupted the ATP's effect on the potassium channels genetically. That's how they found that the mice response to glucose was impaired. This shows that the sensing glucose in the brain plays a part in the control of blood sugar. They also found out that the mice fed with a high fat diet caused the loss of glucose sensing and this may explain the links between high fat diet, obesity and type 2 diabetes.

What have the aforementioned studies got to do with the oral glucose tolerance test? Well, some of the problems with diabetes also occur in pre-diabetes. So if the diagnosis is pre-diabetes, it is wise to have tests regularly to make sure one is not graduating to diabetes.

The test does not have to be glucose tolerance test but the others that are easier to administer. Also watch for symptoms, keep the weight within normal target by being physically active and eating healthy food in moderation.

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