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Cliinical Chemistry 1 (MKEB 2404)

Cliinical Chemistry 1 (MKEB 2404)

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Published by: kiedd_04 on Feb 12, 2009
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01/28/2013

 
DIAGNOSTIC IN CLINICALCHEMISTRY I
MKEB 2404
Title:
Oral glucose tolerance test
Objectives:
To learn on how to interpret oral glucose tolerance test (OGTT)
To understand the mechanisms involved in glucose metabolism
Introduction:
Oral glucose tolerance test (OGTT) is designed to determine how well thebody utilizes glucose after it has been absorbed into the circulation
Methods:
Subjects are in resting condition before this test was performed1.Subject need to fasting for overnight (for at least 10 but not more than 16hours). Water, are allowed but not for other beverage2.A blood sample (finger – prick) was withdrawn for glucose estimation3.A solution containing 75g glucose in 300ml of water was drunk over about4 minutes4.Then, further blood samples are taken after 30 minutes of glucoseingestion (for 2 hours) and the glucose concentration are measured5.A graph of glucose concentration vs time was plotted6.The results was discussed
Results:Time of blood takenCondition [Glucose] in mmol/L
09:401
st
reading (0 minutes)<0.555mmol/L10:252
nd
reading (45 minutes)11.2mmol/L10:503
rd
reading (70 minutes)9.37mmol/L11:194
th
reading (89 minutes)4.78mmol/L11:575
th
reading (127 minutes)3.23mmol/L
1 |Page
 
Interpretation of glucose tolerance test
Venous plasma glucose (mmol/L)
Fasting Two hoursDiabetes unlikely5.5 or less7.8 or lessImpaired glucose tolerance5.5 7.87.8 11.1diabetic7.8 or more11.1 or more
Discussion:
From the result that was performed, the glucose level in the subject is in anormal condition. The slightly drop in the glucose level in the first readingoccur due to error in handling and pipetting the blood sample. Afteraddition of high glucose concentration we can see the sudden increase ofblood glucose concentration in the subject. This occurs in one hour aftertaking the glucose solution. However, after about 1 hour, the glucoseblood level drop back and reach its normal condition again after 2 hours.This results show that the values that was obtain from this experimentwas referred to the person in normal condition.Fasting plasma glucose should be below 5.5mmol/l. Fasting levelsbetween 5.5 and 7.8mmol/l are borderline (impaired glucose tolerance),and fasting levels repeatedly at or above 7.8mmol/l are diagnostic ofdiabetes.The 2 hour glucose level should be below 7.8mmol/l. Levels between thisand 11.1mmol/l indicatesimpaired glucose tolerance. Glucose levelsabove 11.1mmol/l at 2 hours confirm a diagnosis of diabetes.A standard 2 hour OGTT is sufficient to diagnose or exclude all forms ofdiabetes mellitus at all but the earliest stages of development. Longer testshave been used for a variety of other purposes, such as detecting reactivehypoglycemia or defining subsets of hypothalamic obesity. Insulin levelsare sometimes measured to detect insulin resistance or deficiency.The OGTT is of limited value in the diagnosis of reactive hypoglycemia,since normal levels do not preclude the diagnosis, abnormal levels(impaired glucose tolerance) do not prove that the patient's othersymptoms are related to a demonstrated atypical OGTT
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