门诊口服葡萄糖耐量试验患者实施记录卡健康指导的效果

目的 对门诊口服葡萄糖耐量试验的患者实施个性化健康指导,使之有效配合检查.方法 100例门诊口服葡萄糖耐量试验的患者随机分为观察组和对照组各50例,对照组采用传统的口述宣教法,观察组实施试验记录卡进行健康指导,结果进行统计学处理.结果 对照组在获得相应知识内容、合理饮食方面与观察组比较具有显著性差异(P＜0.05).观察组患者对护理工作满意度明显高于对照组(P＜0.01).结论 口服葡萄糖耐量试验患者采用试验记录卡,为门诊开展健康教育提供了一种可行的模式,不仅提高了患者的健康意识,有效的配合各种检查和治疗,并且融洽了护患关系,提高了患者对护理服务的满意度.     

表格式健康教育法在口服葡萄糖耐量试验中的应用

目的探讨表格式健康教育法在口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)中的应用效果。方法将159例需要进行OGTT试验的患者随机分为观察组87例和对照组72例,观察组采用表格式健康教育法,对照组采用传统口头健康教育法。比较两组患者教育的效果及患者对护理工作的满意度。结果两组患者健康教育效果比较,差异具有统计学意义(P<0.05),观察组优于对照组。两组患者对护理工作满意度比较,差异具有统计学意义(P<0.01),观察组优于对照组。结论 OGTT患者采用表格式健康教育,能有效地提高患者配合检查和治疗,融洽护患关系,优于传统健康教育法,值得临床推广应用。     

口服葡萄糖耐量试验采血方法的探讨

目的 探讨一种适宜口服葡萄耐量试验的采血方法。方法 于上臂用留置针穿刺置管后随机分成肝素封管组（A1）和0．9％NS封管组（B1）,分别于空腹、服药后0．5h,1h,2h,3h在留置针采血1.5ml,并同时在对侧上臂直接穿刺采血1.5ml作对照组（A2、B2）,标本配对后测血糖并作统计学处理。此外,用问卷调查30例志愿者对二种采血方法的主观接受程度。结果 经留置针采血与单次穿刺采血的血糖值无显著差异,二种封管液均可使用。30例志愿者全部愿意选择留置针采血法。结论 留置针采血可替代传统的反复直接穿刺采血行OGTT试验。     

改良口服葡萄糖耐量试验温馨提示卡的制作与应用

目的制作一种改良口服葡萄糖耐量试验温馨提示卡,应用于口服葡萄糖耐量试验患者的健康教育。方法采用30 cm×25 cm的透明有机玻璃"坐席牌"1个,内芯双面彩色印刷,插于"坐席牌"内。内芯A面内容为文字描述的口服葡萄糖耐量试验注意事项及试验方法 ,重点内容用红色字突出表现;B面内容为患者的床号、姓名,试验流程需要采血的几个时间点的记录。采血当日清晨护士采集完空腹血,协助患者口服糖水后,将服糖水的时间书写于提示卡上,并以此时间为基准,推算出口服糖水后0.5、1、2、3 h采集血标本的具体时间,由护士采血时书写在提示卡上,对患者予以提示。结果 2013年6月采用改良口服葡萄糖耐量试验温馨提示卡用于OGTT健康教育,通过临床实践,应用效果良好。结论此卡使用方便,使整个试验采血流程更为直观、醒目,让患者一目了然,能提高患者检查依从性。     

口服葡萄糖耐量试验在糖尿病诊断中的探讨

目的：对口服葡萄糖耐量试验(0GTT)诊断糖尿病(DM)进行分析其意义．方法：对286例可疑糖尿病人行OGTF，分别以空腹血糖(FPG)≥7．0mmol／L和OGTT 2h血糖(PG 2h)≥11.1mmol／L作为DM诊断标准。结果：以FPG和PG2h为DM诊断标准，DM的患病率分别是31．81％、44．05％．符合率为60．31％。结论：仅凭FPG诊断DM是不是够的。PG2h是DM诊断的金标准。     

口服葡萄糖耐量试验不良反应预防措施的实验研究

通过对３６０例７５ｇ口服葡萄糖耐量试验不良反应预防措施的实验研究，结果提示：在行口服葡萄糖耐量试验时，化糖水温宜为２０～３０℃、水量为３００ｍｌ、服糖速度为３～５ｍｉｎ，每７５ｇ葡葡糖加入０．２５ｇ柠檬酸矫味剂，在不影响血糖测定值的情况下，可有效地避免或减少不良反应的发生。     

健康人群口服葡萄糖耐量试验不良反应影响因素分析

目的探讨健康人群口服葡萄糖耐量试验（oral glucose tolerance test,OGTT）不良反应发生的影响因素。方法分析某医疗单位596名身体健康的医务人员糖尿病普查OGTT不良反应的发生情况,对性别、试验前休息状况、禁食时间、服葡萄糖水溶量、服糖水速度等不同的受试者OGTT不同反应发生情况进行比较。结果178名受试者出现不同程度的不良反应,发生率为29.9%;同一受试者可出现多项不良反应,共计发生253人次,以恶心最为常见,占24.5%（62/253）。口服葡萄糖水容量〈200 ml组不良反应的发生率为40.7%,高于200～300 ml组（28.5%）和〉300 ml组（25.0%）,但差异无统计学意义（P〉0.05）;服糖水时间〈3min组不良反应的发生率为37.2%,显著高于3～5 min组（P〈0.01）。结论OGTT不良反应的发生率与服糖水速度有关,服糖水时间〈3 min者,OGTT不良反应发生率较高。进行OGTT时,服糖水容量应在200～300 ml,并在3～5 min内服完,有助于减少OGTT不良反应的发生。     

口服葡萄糖耐量试验在糖尿病诊断中的应用

目的探讨口服葡萄糖耐量试验(OGTT)在糖尿病诊断中的应用。方法对149例疑似糖尿病患者进行OGTT检测。结果检出糖尿病前期39例,糖尿病98例。结论 OGTT能提高糖尿病或糖尿病前期的检出率。     

血糖仪在口服葡萄糖耐量试验中的效果观察

WHO糖尿病的诊断一直是以OGTT两小时血糖作为诊断,但传统的静脉穿刺采血送检化验,浪费人力、物力,检验结果报告不及时,不能满足患者及医生双方的要求。近两年来我对16名怀疑有糖尿病的志愿者行静脉穿刺采血,同时行指尖采血。静脉血送检化验室,末梢血在科室自备血糖仪上行     

口服葡萄糖耐量试验1小时血糖升高的意义

1980年WHO首次提出了葡萄糖不耐受的概念和糖尿病的诊断标准.随后,大量的前瞻性流行病学研究显示,在葡萄糖不耐受和糖尿病的情况下,机体已经发生了全身微血管病变.为了更早诊疗,WHO于1985年正式提出糖耐量异常(impaired glucose tolerance,IGT)的概念,并于2002年将IGT定名为糖尿病前期(prediabetes).     

Assessing the shape of the glucose curve during an oral glucose tolerance test

OBJECTIVE:The oral glucose tolerance test (OGTT) is used to define the status of glucose tolerance based on the plasma glucose level at 120 min. The purpose of the present study was to identify parameters that determine the shape of the plasma glucose course measured at 0, 30, 60, 90, and 120 min during an OGTT. RESEARCH DESIGN AND METHODS: OGTT data from 551 subjects (485 with normal glucose tolerance [NGT] and 66 with impaired glucose tolerance [IGT]) were analyzed. We distinguished between "monophasic," "biphasic," and unclassified glucose shapes. A "shape" index based on the extent and the direction of the plasma glucose change in the second hour allowed us to treat shape as a continuous variable. RESULTS: In the biphasic group, the NGT-to-IGT ratio was slightly higher (173/20 vs. 209/40, P = 0.08) and the male-to-female ratio was lower (60/133 vs. 120/129, P = 0.0003). Subjects with a biphasic shape had significantly lower age, BMI, waist-to-hip ratio (WHR), HbA(1c), plasma glucose, and area under the insulin curve (insulin(AUC)) and a better estimated insulin sensitivity and secretion (using validated indexes) than monophasic subjects (all P < 0.05). By adjusting this shape index for glucose(AUC) (as continuous measure of glucose tolerance), correlations with age, BMI, WHR, HbA(1c), and insulin(AUC) were completely abolished. The adjusted shape index was still higher in female than in male subjects but lower in IGT than in NGT subjects (both P = 0.0003). Finally, we tested common polymorphisms in insulin receptor substrate (IRS)-1, IRS-2, calpain-10, hepatic lipase, and peroxisome proliferator-activated receptor-gamma for association with the shape index. CONCLUSIONS: We conclude that the plasma glucose shape during an OGTT depends on glucose tolerance and sex. In addition, genetic factors seem to play a role. The shape index may be a useful metabolic screening parameter in epidemiological and genetic association studies.     

Serum concentration of small dense low-density lipoprotein-cholesterol during oral glucose tolerance test and oral fat tolerance test

BACKGROUND: Small dense low-density lipoprotein (sdLDL) is well known as an atherogenic lipoprotein. We developed a new assay to measure serum concentration of sdLDL-cholesterol (sdLDLC). Using this assay, we reported a unique circadian rhythm of sdLDLC. We determined whether a glucose intake and/or a fat intake affects on serum sdLDLC concentration and determined the modulators of serum sdLDLC concentration. METHODS: Ten healthy volunteers were recruited to perform both a 75 g oral glucose tolerance test (OGTT) and an oral fat tolerance test (OFTT) to determine the effects of glucose and fat ingestion separately. Blood was measured for sdLDLC concentration and other valuables. RESULTS: Serum concentrations of total cholesterol, LDLC, remnant-like particles-cholesterol (RLPC), and apolipoprotein B significantly decreased during OGTT (p<0.05). SdLDLC also decreased and was a minimum at 2 h after glucose ingestion and increased to the baseline by 3 h. The sdLDLC decrease was seen while serum insulin level was high. The change of sdLDLC during OGTT had greater inverse correlationship with that of serum insulin level (r=-0.74, p<0.01) than that of plasma glucose level (r=-0.69, p=0.04). After fat ingestion, triglyceride and RLPC increased remarkably (p<0.01) but sdLDLC, LDLC, apolipoprotein B, and insulin did not change significantly. CONCLUSIONS: Serum concentration of sdLDLC was not affected by a fat intake but by a glucose intake. The change of sdLDLC was associated by that of serum insulin level, suggesting that insulin can be one of the key modulator of serum sdLDLC level as well as LDL metabolism.     

急性冠状动脉综合征患者口服糖耐量试验检查时机选择

目的探讨急性冠状动脉综合征（ACS）患者口服糖耐量试验（OGTr）的检查时机与安全性。方法选择2007年1月至2012年1月232例ACS住院患者,于病情稳定后及出院后3个月随访时行OGTr,并注意患者心电图和症状变化。结果病情稳定后于出院前OGTT检查发现血糖正常占40．95％（95／232）、糖尿病25．00％（58／232）、糖耐量减低34．05％（79／232）、空腹血糖受损2．59％（6／232）,与出院后3个月[血糖正常占39．91％（89／215）,糖尿病22．33％（48／215）,糖耐量减低33．95％（73／215）,空腹血糖受损2．33％（5／215）]比较差异均无统计学意义（x2值分别为0．051、0．441、0．001、0．032,P均〉0．05）,心电图sT段比较差异亦无统计学意义[（-0．12±0．08）mV与（-0．15±0．12）mV,t=0．23,P=0．85）。OGTr检查时不良反应少。结论ACS患者为糖代谢异常的高危人群,病情稳定后行OGTT是安全的,对于ACS患者都应常规行OGTT,及早发现糖代谢异常患者,并进行相应干预及治疗。     

Revision of the oral glucose tolerance test: a pilot study

Nausea and vomiting have been recurrent problems with the oral glucose tolerance tests (OGTT) used to diagnose diabetes. We believe the nausea is associated with delayed gastric emptying caused by the high osmolarity of the glucose solution. In our pilot study, both the "standard" 100-g glucose OGTT and our new modified (lower osmolar) glucose solution were evaluated. Considerably delayed gastric emptying (along with severe nausea) was consistently noted with the standard OGTT. No nausea and a much more rapid gastric emptying time were recorded when the modified glucose solution was administered. We were able to diagnose diabetes (by using Wilkerson's point system) when our modified OGTT was administered to type 2 diabetics. We plan to develop a more physiological, more reproducible, and better tolerated OGTT to diagnose diabetes more accurately in the general population.     

Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity

OBJECTIVE: The oral glucose tolerance test (OGTT) has often been used to evaluate apparent insulin release and insulin resistance in various clinical settings. However, because insulin sensitivity and insulin release are interdependent, to what extent they can be predicted from an OGTT is unclear. RESEARCH DESIGN AND METHODS: We studied insulin sensitivity using the euglycemic-hyperinsulinemic clamp and insulin release using the hyperglycemic clamp in 104 nondiabetic volunteers who had also undergone an OGTT. Demographic parameters (BMI, waist-to-hip ratio, age) and plasma glucose and insulin values from the OGTT were subjected to multiple linear regression to predict the metabolic clearance rate (MCR) of glucose, the insulin sensitivity index (ISI), and first-phase (1st PH) and second-phase (2nd PH) insulin release as measured with the respective clamps. RESULTS: The equations predicting MCR and ISI contained BMI, insulin (120 min), and glucose (90 min) and were highly correlated with the measured MCR (r = 0.80, P < 0.00005) and ISI (r = 0.79, P < 0.00005). The equations predicting 1st PH and 2nd PH contained insulin (0 and 30 min) and glucose (30 min) and were also highly correlated with the measured 1st PH (r = 0.78, P < 0.00005) and 2nd PH (r = 0.79, P < 0.00005). The parameters predicted by our equations correlated better with the measured parameters than homeostasis model assessment for secretion and resistance, the delta30-min insulin/delta30-min glucose ratio for secretion and insulin (120 min) for insulin resistance taken from the OGTT. CONCLUSIONS: We thus conclude that predicting insulin sensitivity and insulin release with reasonable accuracy from simple demographic parameters and values obtained during an OGTT is possible. The derived equations should be used in various clinical settings in which the use of clamps or the minimal model would be impractical.     

Impaired glucose tolerance of pregnancy is a heterogeneous metabolic disorder as defined by the glycemic response to the oral glucose tolerance test

OBJECTIVE: Gestational diabetes mellitus (GDM), defined by two abnormal glucose values on a 3-h oral glucose tolerance test (OGTT), is associated with insulin resistance and a low serum concentration of adiponectin. The metabolic implications of impaired glucose tolerance (IGT) of pregnancy (i.e., a single abnormal value on an OGTT), however, are not well established. We sought to evaluate the metabolic phenotype of pregnant women with IGT in relation to the timing of their isolated hyperglycemia. RESEARCH DESIGN AND METHODS: A cross-sectional study was performed in pregnant women undergoing a 3-h, 100-g OGTT. The OGTT stratified participants into four groups: 1) GDM (n = 48), 2) 1-h IGT (single elevated value at 1 h) (n = 15), 3) 2-h/3-h IGT (single elevated value at either 2 or 3 h) (n = 23), and 4) normal glucose tolerance (NGT) (n = 93). Insulin sensitivity was measured by the validated insulin sensitivity index (IS(OGTT)) of Matsuda and DeFronzo. RESULTS: Measures of severity of glycemia (fasting glucose, area under the glucose curve from the OGTT, and glucose challenge test result) were highest in the GDM group, followed by the 1-h IGT, 2-h/3-h IGT, and NGT groups, respectively (each trend P < 0.0001). Consistent with this finding, IS(OGTT) was highest in the NGT group (5.1), followed by the 2-h/3-h IGT (4.6), 1-h IGT (3.8), and GDM (3.2) groups (trend P < 0.0001). Furthermore, on multiple linear regression analysis of IS(OGTT), both GDM and 1-h IGT were independently associated with reduced insulin sensitivity (whereas 2-h/3-h IGT was not). Mean adjusted adiponectin was highest in the NGT group (15.7 microg/ml), followed by the 2-h/3-h IGT (15.6 microg/ml), 1-h IGT (13.7 microg/ml), and GDM (12.0 microg/ml) groups (trend P = 0.0024). CONCLUSIONS: The metabolic implications of IGT in pregnancy vary in relation to the timing of the abnormal glucose value from the diagnostic OGTT. The metabolic phenotype associated with 1-h IGT resembles that of GDM, whereas the phenotype associated with 2-h/3-h IGT exhibits similarity to that of NGT.