icon-nav-help
Need Help

Submit your question to our team of health care professionals.

icon-nav-current-questions
Current Question

See what's on the mind of the community right now.

icon-conf-speakers-at-a-glance
Meet the Team

Learn more about our world-renowned team.

icon-nav-archives
CWD Answers Archives

Review the entire archive according to the date it was posted.

CWD_Answers_Icon
October 24, 2002

Diagnosis and Symptoms

advertisement
Question from Tell City, Indiana, USA:

My 14 year old daughter (height: 5 feet; weight: 94 pounds) had a blood sugar of about 145 mg/dl [13.6 mmol/L] when she was sick after she had just finished drinking a 16 ounce bottle of orange juice, so her doctor did a three-hour oral GTT. The results were:

   Time   
    Blood Glucose   

4%
65 mg/dl [3.6 mmol/L]

fasting
102 mg/dl [5.7 mmol/L]

one-half hour
230 mg/dl [12.8 mmol/L]

one hour
169 mg/dl [9.4 mmol/L]

two hours
138 mg/dl [7.7 mmol/L]

three hours
114 mg/dl [6.3 mmol/L]

The doctor said that she has borderline diabetes (which I believe is now called prediabetes) and suggested diet, exercise, and a retest in three months. However, everything that I have read has told me that she should have been given 50 or 75 grams of glucose, and that the maximum for a child is 75 grams, but she was given 100 grams of glucose. Could the 100 grams of glucose her one-half hour blood glucose was so high? Wouldn’t this make a difference in the results? Do you think I should have the OGTT done again with 50 or 75 grams?

I have asked the doctor him the same questions I’m asking you, and he really could not say for sure if the 100 gram would have made a difference or not. He told me he would read up on it, but said someone without diabetes would never have blood glucose over 200 mg/dl [11.1 mmol/L] no mater how much sugar intake they had. Is that true? Hope you can help me with this.

Answer:

From: DTeam Staff

Ah yes, the vagaries of the oral glucose tolerance test! That’s why most don’t rely on it for diagnosing diabetes. I rarely do them for all the reasons you say.

That said, I would worry about a 102 mg/dl [5.7 mmol/L] fasting level more than anything else. It is too high and bears watching. Likewise, 138 mg/dl [7.7 mmol/L] at two hours seems high to me too, but it might be dark by the amount of glucose, etc.

I wouldn’t do another OGTT, but I would monitor blood glucose at home (some fasting and some postprandial). One can do years of glucoses for the cost of the GTT.

LD