Next, a glucose tolerance test was performed. On the day of the exam Jamie was t

Question

Next, a glucose tolerance test was performed. On the day of the exam Jamie was told to refrain from eating for 8 hours. Water was allowed but no other beverages. Jamie was scheduled for a 3 hour test.

Her weight was recorded at 122 lbs.

She was given a solution of concentrated glucose to drink. It contained 100 gram of glucose. Blood samples were taken at the beginning of the test and hourly thereafter for 3 hours. The results were as follows:

Initial blood glucose level: 80 mg/dL

1 hour: 160 mg/dL

2 hour: 120 mg/dL

3 hour: 95 mg/dL

A blood sample was also checked for A1C. The value was 5.4.

6. Discuss the above results. What levels would indicate diabetes mellitus? What is A1C? How is it indicative of diabetes mellitus? Should multiple tests be performed? Do you think Jamie has the disease? Why or why not?

Explanation / Answer

Testing for diabetes is important because early diabetes has no symptoms. The oral glucose tolerance test (OGTT) along with A1C are the best tools available to diagnose diabetes - a lifelong disease. This testing helps health care providers to find and treat diabetes before complications occur and treat prediabetes, thus preventing type 2 diabetes from developing.

Glucose tolerance test- This test measure the ability of body's cell to absorb glucose, after a given amount of glucose is ingested. It helps diagnose type 2 diabetes and gestational diabetes. Type 2 diabetes is the most common type of diabetes, and it usually develops over years during adulthood and gestational diabetes occurs when a pregnant woman who doesn't have diabetes before pregnancy has high glucose levels as a result of the pregnancy.

There are 3 versions of OGTT: 1-hr test, the 2- hour test and the 3-hour test.

A1C test- is a blood test which provides information about a person's average blood glucose levels over a past 3 months. This test is also called hemoglobin A1c or glycohemoglobin test. The A1C test is based on the attachment of glucose to hemoglobin, the protein in RBC that carries oxygen. In a healthy individual, RBC live in blood circulation for about 100-120 days henceforth offers an indication of longer term blood glucose. When the blood glucose levels are elevated, some of the glucose binds to hemoglobin A, and the combined result is called glycated hemoglobin forms and it persists for the life span of RBC, about 4 months. The A1C level directly correlates to the average blood glucose level over the previous 8-12 weeks.

The A1C test result is repoted as a percentage. The higher the %, the higher a person's blood glucose levels have been. Normal A1C level is below 5.7 percent.

In the given case Jamie underwent OGTT and A1C tests.

Discussion of Jamie's OGTT:

Jamie's fasting blood glucose level is 80mg/dL. A value less than 100mg/dL is considered normal.

One hour after drinking the glucose solution, if blood glucose level is lower than 180mg/dL is considered normal. ( Jamie's OGTT result after an hour is 160mg/dL)

Twohours after drinking the glucose solution, if blood glucose level is lower than 155mg/dL is considered normal. (Jamie's OGTT result after two hours is 120 mg/dL)

Three hours after drinking the glucose solution, if blood glucose level is lower than 140mg/dL is considered normal.(Jamie's OGTT result after 3 hours is 95 mg/dL.

Jamie's A1C test is 5.4 and is considered normal.

So Jamie doesn't have diabetes as all the values are normal.

Multiple tests should be performed if one of the tests is higher than normal. So no need of multiple tests for Jamie.

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