The patient should have been fasting for the previous 8-14 hours (water is allowed).
Usually the OGTT is scheduled to begin in the morning (0700-0800) as glucose tolerance exhibits a diurnal rhythm with a significant decrease in the afternoon. A zero time (baseline) blood sample is drawn.
The patient is then given a glucose solution to drink. The standard dose since the late 1970s has been 1.75 grams of glucose per kilogram of body weight, to a maximum dose of 75 g. It should be drunk within 5 minutes. Prior to 1975 a dose of 100 g was often used.
Blood is drawn at intervals for measurement of glucose (blood sugar), and sometimes insulin levels. The intervals and number of samples vary according to the purpose of the test. For simple diabetes screening, the most important sample is the 2 hour sample and the 0 and 2 hour samples may be the only ones collected. In research settings, samples may be taken on many different time schedules.
If renal glycosuria (sugar excreted in the urine despite normal levels in the blood), then urine samples may also be collected for testing along with the fasting and 2 hour blood tests.
The 2 hour glucose level should be below 7.8 mmol/l (140 mg/dl). Levels between this and 11.1 mmol/l (200 mg/dl) indicate "impaired glucose tolerance." Glucose levels above 11.1 mmol/l (200 mg/dl) at 2 hours confirms a diagnosis of diabetes.
|Glucose levels||NORMAL||impaired fasting glycaemia (IFG)||impaired glucose tolerance (IGT)||Diabetes Mellitus (DM)|
|(mmol/l)||<6.1||<7.8||> 6.1 & <7.0||<7.8||<7.0||>7.8||>7.0||>11.1|
|(mg/dl)||<100||<140||>100 & <126||<140||<126||>140||>126||>200|
The OGTT is of limited value in the diagnosis of reactive hypoglycemia, since (1) normal levels do not preclude the diagnosis, (2) abnormal levels do not prove that the patient's other symptoms are related to a demonstrated atypical OGTT, and (3) many people without symptoms of reactive hypoglycemia may have the late low glucoses that are said to be characteristic. 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).
When the glucose is given intravenously it is termed an intravenous glucose tolerance test (IVGTT). This has been used in the investigation of early insulin secretion abnormalities in prediabetic states.