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ORAL GLUCOSE TOLERANCE TEST

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

Because of the increasing occurrence of diabetes in younger ages, NHANES has added this component to the examination protocol to reassess the prevalence of diabetes and impaired glucose tolerance (IGT) in the U.S. population. Diabetes is a large, growing, and costly public health problem in the United States and disproportionately affects racial and ethnic minorities. About 17 million Americans have diabetes and over 1 million new cases of diabetes are diagnosed each year. Diabetes is the leading cause of kidney failure, nontraumatic lower extremity amputation, and blindness in working-age adults, and an estimated $135 billion was spent on direct and indirect medical costs for diabetes in 2002. Alarmingly, type 2 diabetes (formerly considered an adult disease) is now being diagnosed in children and adolescents and there has been a large increase in diagnosed diabetes among adults Nation initiates efforts to prevent diabetes among persons with prediabetes. These data on IGT and prediabetes are critical to targeting, designing, and evaluating prevention efforts such as DHHS’s STEPS program and efforts by the National Diabetes Education Program. A fasting glucose blood test is performed on all participants 12 years and older who are examined in the morning session after a 9-hour fast. After the initial venipuncture, participants are asked to drink a calibrated dose (generally 75 milligrams) of Trutol® and to have a second venipuncture 2 hours (plus or minus 15 minutes) after drinking the Trutol. There are minimal risks associated with this procedure. The package label for Trutol lists the following rare but known adverse reactions: nausea, vomiting, abdominal bloating, and headache. In addition, there is a rare incidence of hypoglycemia. The risks associated with venipuncture include excessive bleeding, fainting/feeling lightheaded, hematoma, infection, and multiple punctures to identify veins. Participants eligible for OGTT will have to endure the discomfort of a second venipuncture; however, they will benefit by the report of findings that will inform them if they have impaired glucose tolerance. The results from the OGTT will be reported to parents of participants 12-17 years and directly to participants 18 years and older in the Final Report of Findings. If the 2-hour blood glucose values are equal to or greater than 140 mg/dL, (i.e., glucose levels consistent with impaired glucose tolerance or diabetes mellitus), an early report will be sent.

The oral glucose tolerance test (OGTT) is a widely used diagnostic procedure that provides valuable insights into an individual's ability to process glucose. It involves the administration of a standardized glucose solution and the subsequent measurement of blood glucose levels at specific time intervals. The OGTT is commonly employed in the diagnosis of diabetes mellitus, gestational diabetes, and impaired glucose tolerance. It plays a crucial role in assessing metabolic health, guiding treatment decisions, and monitoring the effectiveness of interventions.

Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, resulting from either insufficient insulin production or impaired insulin action. It is a major public health concern, with an increasing prevalence worldwide. Early diagnosis and appropriate management of diabetes are essential to prevent complications and improve overall health outcomes. The OGTT serves as one of the key diagnostic tests for diabetes, providing valuable information about an individual's glucose tolerance and the efficiency of their insulin response.

The OGTT begins with a period of fasting, typically overnight, to ensure a standardized baseline. Upon arrival at the testing facility, the individual's fasting blood glucose level is measured. Subsequently, a glucose solution containing a predetermined amount of glucose is