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Glucose tolerance test (GTT)

This test measures the ability of a person to handle a standard amount of glucose. The glucose load is usually given orally.

For three days before the test, the person should consume a diet consisting of at least 150 g carbohydrates per day. Antidiabetic drugs are discontinued. Fasting blood glucose/sugar is estimated. The person is then given a flavoured glucose solution (75 g or 50 g or 100 g glucose) to drink. Blood glucose is estimated every half an hour for the next two to three hours. Corresponding urine samples are tested for glucose/sugar. The person should not smoke or exercise during the test. Sometimes the blood glucose values are plotted as a curve called the glucose tolerance curve. The glucose content of urine samples is recorded.

In a normal person, the fasting blood glucose level is between 70 and 100 mg/dl. After drinking the glucose solution, it rises within half an hour or so but does not exceed about 150 mg/dl. The blood glucose returns to the fasting level within 2 hours. Glucose is not spilled in urine at any stage.

The glucose load stimulates the secretion of insulin which disposes of the glucose by using it in cells or storing it in depots. In a normal person the secretion of insulin is prompt and adequate, hence the blood glucose level does not rise excessively after a glucose load and returns to the fasting level within two hours. In diabetes, the secretion of insulin is neither prompt nor adequate. Therefore, after a glucose load, the blood glucose level shoots up and does not return to the fasting level within two hours. The fasting blood glucose level may be elevated when the basal secretion of insulin is reduced. Glucose spills into urine when the blood glucose level exceeds the renal threshold for glucose.

GTT is superfluous when blood glucose levels are high. It is also not necessary for a diabetic already on insulin or oral drugs. The blood glucose levels fasting and 2 hours after a glucose load suffice for diagnosis of diabetes, (see Ch.3)

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Glucose tolerance test (GTT)