The oral glucose tolerance test (OGTT) revisited

Abstract The oral glucose tolerance test (OGTT) has been the mainstay for diagnosing diabetes for decades. Recently, the American Diabetes Association (ADA) suggested abandoning the OGTT, while resorting to a simpler screening test, exclusively based on baseline fasting blood glucose concentration....

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Bibliographic Details
Published inEuropean journal of internal medicine Vol. 22; no. 1; pp. 8 - 12
Main Authors Bartoli, E, Fra, G.P, Schianca, G.P. Carnevale
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 01.02.2011
Subjects
Blood Glucose - metabolism
Diabetes
Diabetes Mellitus - blood
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Early Diagnosis
Evidence-Based Medicine
Fasting - blood
Glucose Intolerance - diagnosis
Glucose Tolerance Test
Glycated Hemoglobin A - metabolism
Glycosylated haemoglobin
Humans
Insulin
Internal Medicine
Italy - epidemiology
Mass Screening
OGTT
Predictive Value of Tests
Sensitivity and Specificity
β-cell function
β-cell function
Glycosylated haemoglobin
Diabetes
OGTT
Insulin
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Summary:Abstract The oral glucose tolerance test (OGTT) has been the mainstay for diagnosing diabetes for decades. Recently, the American Diabetes Association (ADA) suggested abandoning the OGTT, while resorting to a simpler screening test, exclusively based on baseline fasting blood glucose concentration. This review article rewinds the history of OGTT and its recent advancements, and compares its power in detecting early diabetes with that of fasting blood glucose alone. The key point is that there are more diabetics originating from a population with normal fasting blood glucose than from subjects with impaired fasting glucose, those who can be detected by the new ADA recommendations. Conversely, the OGTT detects more efficiently early diabetes as well as subjects with IGT, as the glycemia at the second hour seems crucial as a diagnostic tool. We discuss the different significance of fasting versus second hour glycemia during OGTT, according to different mechanisms of glucose homeostasis. Finally, we provide recent evidence on very simple additional information that can be obtained from the OGTT, which renders this test even more useful, discussing pathophysiologic significance.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2010.07.008