What is the Oral Glucose Tolerance Test?

The oral glucose tolerance test (OGTT), also referred to as the glucose tolerance test, measures the body’s
ability to metabolize glucose, or clear it out of the bloodstream. The test can be used to diagnose diabetes,
gestational diabetes (diabetes during pregnancy) or prediabetes (a condition characterized by higher-than-
normal blood sugar levels that can lead to type 2 diabetes).

How Is the Test Conducted?

Those taking the OGTT to diagnose diabetes or prediabetes who are not pregnant should eat a normal,
balanced diet the week before taking the test. Experts recommend that this diet include at least 150 to 200
grams of carbohydrates per day. Patients must fast for at least 8 to 12 hours before having the test.

After fasting, blood is drawn to establish a fasting glucose level. Next, a patient must quickly drink a sugary
(glucose-rich) beverage. Typically, the drink contains 75 grams of carbohydrates, although other amounts
are possible. Blood will be drawn at various intervals to measure glucose levels, usually one hour and two
hours after the beverage is consumed.

What Does the Test Indicate?

he test reveals how quickly glucose is metabolized from the bloodstream for use by cells as an energy
source. The normal rate of glucose clearing depends on the amount of glucose ingested. After fasting, the
normal blood glucose rate is 60 to 100 mg/dL (milligrams per deciliter).

For 75 grams of glucose, normal blood glucose values are:

• 1 hour: less than 200 mg/dL

• 2 hours: less than 140 mg/dL. Between 140-200 mg/dL indicates impaired glucose tolerance
(prediabetes). If test results are in this range, a patient is at an increased risk for developing diabetes.
Greater than 200 mg/dL indicates diabetes

The Hemoglobin A1c (HbA1c) Test for Diabetes

Importance of Hemoglobin A1c Test

The hemoglobin A1c test -- also called HbA1c, glycated hemoglobin test, or glycohemoglobin -- is an
important blood test used to determine how well your diabetes is being controlled. Hemoglobin A1c provides
an average of your blood sugar control over a six to 12 week period and is used in conjunction with home
blood sugar monitoring to make adjustments in your diabetes medicines.

Hemoglobin is a substance within red blood cells that carries oxygen throughout your body. When your
diabetes is not controlled (meaning that your blood sugar is too high), sugar builds up in your blood and
combines with your hemoglobin, becoming "glycated." Therefore, the average amount of sugar in your blood
can be determined by measuring a hemoglobin A1c level. If your glucose levels have been high over recent
weeks, your hemoglobin A1c test will be higher. The amount of hemoglobin A1c will reflect the last several
weeks of blood sugar levels, typically encompassing a period of 120 days.

What's a Normal Hemoglobin A1c Test?

For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 6%. Because
studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the
goal for people with diabetes is an hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher
the risks of developing complications related to diabetes.

People with diabetes should have this test every three months to determine whether their blood sugars have
reached the target level of control. Those who have their diabetes under good control may be able to wait
longer between the blood tests, but experts recommend checking at least 2 times a year.

Patients with diseases affecting hemoglobin such as anemia may get abnormal results with this test. Other
abnormalities that can affect the results of the hemoglobin A1c include supplements such as vitamins C and
E and high cholesterol levels. Kidney disease and liver disease may also affect the result of the hemoglobin
A1c test.
Uses for glycosylated hemoglobin

• Diagnosis of diabetes mellitus: Glycosylated hemoglobin concentrations above reference intervals

indicate a persistent hyperglycemia and are seen in diabetes mellitus.
Stress hyperglycemias will not elevate blood glucose concentrations for a long enough period of time
to increase the glycosylated hemoglobin concentration.
However, animals with diabetes mellitus of only a few weeks duration may have glycosylated
hemoglobin concentrations within reference intervals.
• Response to insulin therapy: Glycosylated hemoglobin can be used to monitor response to insulin
therapy in diabetic patients, however fructosamine is probably better for this purpose as it will reflect
changes in glucose concentration more rapidly than glycosylated hemoglobin.

Blood Glucose

A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes
from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps
your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the
amount of glucose in the blood rises.

Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to
release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high
over time can damage your eyes, kidneys, nerves, and blood vessels.

Several different types of blood glucose tests are used.

• Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It
is often the first test done to check for prediabetes and diabetes.
• 2-hour postprandial blood sugar measures blood glucose exactly 2 hours after you start eating a
meal.
• Random blood sugar (RBS) measures blood glucose regardless of when you last ate. Several
random measurements may be taken throughout the day. Random testing is useful because glucose
levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely
may mean a problem. This test is also called a casual blood glucose test.
• Oral glucose tolerance test is used to diagnose prediabetes and diabetes. An oral glucose
tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that
contains glucose. This test is commonly used to diagnose diabetes that occurs during pregnancy
(gestational diabetes). For more information, see the medical test Oral Glucose Tolerance Test. This
test is not commonly used to diagnose diabetes in a person who is not pregnant.

The American Diabetes Association recommends keeping blood sugar levels in a range based on your age.
Discuss these goals with your doctor and diabetes educator.

Before meals:

• 70 - 130 mg/dL for adults

• 100 - 180 mg/dL for children under age 6
• 90 - 180 mg/dL for children 6 - 12 years old
• 90 - 130 mg/dL for children 13 - 19 years old

At bedtime:

• Less than 180 mg/dL for adults

• 110 - 200 mg/dL for children under age 6
• 100 - 180 mg/dL for children 6 - 12 years old