Talk:Glucose tolerance test
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Inkblot tests?
[edit]Removed the following passage that compares the use of the OGGT to Rorschach tests. This analogy is confusing and not terribly exact. Using a glucose tolerance in this context resembles use of a Rorschach test in that it is often used to support a diagnosis that the patient and doctor are already reaching agreement on based on other evidence, but it is inadequate by itself to confirm or refute the diagnosis (unlike its use for diabetes). Freder1ck 23:15, 1 January 2007 (UTC)Freder1ck
- I thought the sentence is quite clear and vivid: use of the OGTT for diagnosing hypoglycemia and use of the Rorschach for diagnosing anything are quite comparable: both tests have repeatedly shown an inability to separate those with the condition from the general population when doctor and patient are blinded, but in the real world both are interpreted selectively to confirm diagnoses already reached by other methods. In other words both are poor diagnostic tools for those purposes, but many practitioners continue to use them. Patients should be skeptical that either test yields an independent and objectively reproducible confirmation of any diagnosis. alteripse 03:18, 2 January 2007 (UTC)
- Indeed. I would imagine that there are few psychological tests that offer reproducible results comparable to chemical or biological tests. But as it stands, the article presumes that a general reader will see the Rorschach as unreliable and subjective. The statement is unencyclopedic in that it presumes specialized knowledge of another subject and even a particular opinion of that subject. I would hope that an argument by analogy would offer enough detail on the secondary subject so that the reader would grasp what claim is being made. As it stands, the only thing I gather from this passage is that the author (alteripse, I presume), doesn't like the use of GTT for determining reactive hypoglycemia and also doesn't like Rorschach tests. Since the use of Rorschach is controversial, then I would hope you would discuss your criticism on the Rorschach test page. Freder1ck 03:43, 2 January 2007 (UTC)Freder1ck
- I will provide some refs for the unreliability of the OGTT as a stand-alone test for diagnosing hypoglycemia. This not simply my opinion, but is the current consensus among endocrinologists interested in hypoglycemia: you will not find many internet sites mentioning use of the OGTT for this purpose from universities and medical centers. If the Rorschach article is thorough and referenced it will already have citations for the studies documenting its essentially subjective nature. The relevant point for this article is that diabetes is defined and diagnosed by the objective result of an OGTT, while no OGTT studies have been able to distinguish people with hypoglycemic symptoms from those without. Both the Rorschach test and the OGTT for hypoglycemia are relics of mid-twentieth century medicine whose objective usefulness could not be validated despite persistent use by a dwindling minority of old-style practitioners. alteripse 05:20, 2 January 2007 (UTC)
- If I may clarify, my question was not regarding the reliability of the OGTT for reactive hypoglycemia. The difficulty with this section is the analogy between OGTT and the Rorschach. Your analogy works for the person well-read in psychology who shares your opinion of the Rorschach, but falters for the general reader. The Rorschach inkblot test article says that the test is the second most used test for forensic assessment; if this statement is correct, then I wonder about the utility of your analogy, at least for those who do not already share your point of view... Freder1ck 22:35, 2 January 2007 (UTC)Freder1ck
- I will provide some refs for the unreliability of the OGTT as a stand-alone test for diagnosing hypoglycemia. This not simply my opinion, but is the current consensus among endocrinologists interested in hypoglycemia: you will not find many internet sites mentioning use of the OGTT for this purpose from universities and medical centers. If the Rorschach article is thorough and referenced it will already have citations for the studies documenting its essentially subjective nature. The relevant point for this article is that diabetes is defined and diagnosed by the objective result of an OGTT, while no OGTT studies have been able to distinguish people with hypoglycemic symptoms from those without. Both the Rorschach test and the OGTT for hypoglycemia are relics of mid-twentieth century medicine whose objective usefulness could not be validated despite persistent use by a dwindling minority of old-style practitioners. alteripse 05:20, 2 January 2007 (UTC)
- Indeed. I would imagine that there are few psychological tests that offer reproducible results comparable to chemical or biological tests. But as it stands, the article presumes that a general reader will see the Rorschach as unreliable and subjective. The statement is unencyclopedic in that it presumes specialized knowledge of another subject and even a particular opinion of that subject. I would hope that an argument by analogy would offer enough detail on the secondary subject so that the reader would grasp what claim is being made. As it stands, the only thing I gather from this passage is that the author (alteripse, I presume), doesn't like the use of GTT for determining reactive hypoglycemia and also doesn't like Rorschach tests. Since the use of Rorschach is controversial, then I would hope you would discuss your criticism on the Rorschach test page. Freder1ck 03:43, 2 January 2007 (UTC)Freder1ck
I am not really sure the analogy is really that important in the context of the pathophysiology of Diabetes. The application and interpretation of OGTT has different methodology and mechanics within the disease than Rorschach tests in psychological disorders. SteveD 17:38 15th November 2009. —Preceding unsigned comment added by 122.104.6.9 (talk) 06:38, 15 November 2009 (UTC)
interpretation
[edit]As diagnostic for diabetes, several sources list: fasting > 92mg/dL; 1hr OGTT > 180mg/dL; 2hr OGTT > 153mg/dL... This is not what is listed in the article. Which is correct? — Preceding unsigned comment added by 98.70.135.63 (talk) 00:06, 7 June 2013 (UTC)
The interpretation section is mixing up information regarding gestational diabetes and type 2 diabetes. None of the cited references actually talk about a 1hr OGTT result for type 2 diabetes, and only the 2r OGTT result is considered. For gestational diabetes, the 1hr result seems to be relevant. Someone who knows this stuff better than me should clean up the interpretation section.-- Sarang — Preceding unsigned comment added by 117.223.108.121 (talk) 05:00, 18 October 2018 (UTC)
History
[edit]The glucose tolerance test was first described by Jerome Conn, of Conn's disease fame.
Conn JW. Interpretation of the glucose tolerance test.The necessity of a standard preparatory diet. Am J Med Sci. 1940; 199: 555-564. — Preceding unsigned comment added by 118.209.142.56 (talk) 12:54, 13 July 2014 (UTC)
Dead Truct
[edit]Definition : It is a pathological process when a tooth is subjected to external stimuli. The odontoblastic process of dentinal tubules becomes lost or distorted.
Dr.pipra (talk) 04:39, 11 August 2014 (UTC)
Gestational Diabetes
[edit]A section should be included for gestational diabetes of which there are three different OGTT:
- 50 gram non-fasting OGTT which when positive gives indication for a 100 gram OGTT
- 100 gram fasting OGTT (3 hour test) which show Gestational Diabetes diagnostic criteria on that page. Should it be included here as well?
- 75 gram fasting OGTT (2 hour test)
Regarr (talk) 16:27, 16 August 2014 (UTC)
Results: Definition of impaired fasting glucose
[edit]The results section of this page is a bit confusing (aren't the 75 gram and 2 hour OGTT the same test?)
And it has incorrect information. According to the NIH[1], the fasting glucose levels are set as:
- 99 or below: normal
- 100 - 125: prediabetes
- > 126: diabetes
The listed values in the results section show 110 as the cutoff. Regarr (talk) 16:27, 16 August 2014 (UTC)
Before the Test?
[edit]In the section "Results", it says, for the serum glucose test that you do at home with the meter, your fasting glucose should be below 6.1. At the bottom of the section it says that when you go to the doctor for the Glucose Tolerance test that your fasting blood glucose should be below 5.1. If the test hasn't started yet, how can you have two different allowable levels? This can't be right.Longinus876 (talk) 15:12, 5 October 2014 (UTC)
Sample method: capillary and venous
[edit]Re the difference between capillary and venous testing: older WHO documents find fairly consistently that capillary values are similar at 0h, and about 1.1mmol/l higher at 2 hours, reasonably consistent with Nevander, Sofia; Landberg, Eva; Blomberg, Marie; Ekman, Bertil; Lilliecreutz, Caroline (26 November 2020). "Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II". Diagnostics. 10 (12): 1011. doi:10.3390/diagnostics10121011. ISSN 2075-4418. Older sources: https://apps.who.int/iris/rest/bitstreams/51753/retrieve (1994). https://applications.emro.who.int/dsaf/dsa509.pdf (2006). This could be added to the article, but should perhaps be discussed first. I also added "A 2020 study on pregnant women for gestational diabetes mellitus (GDM) found that 0-hour venous and capillary levels were similar, but that 2-hour samples were different. The authors compared their study with others, and concluded that capillary samples could be used for diagnosis of GDM during pregnancy using corrected cutoffs with acceptable accuracy in an antenatal care setting." Pol098 (talk) 23:35, 19 June 2023 (UTC)