The doctor may recommend that the patient donate blood for sugar with a load in the following cases:
- type 1 or type 2 diabetes. Testing is carried out in order to assess the effectiveness of the prescribed treatment regimen, as well as to find out if the disease has worsened;
- insulin resistance syndrome. The disorder develops when the cells do not perceive the hormone produced by the pancreas;
- during the bearing of a child (if a woman suspects a gestational type of diabetes);
- the presence of excess body weight with moderate appetite;
- digestive system dysfunctions;
- disruption of the pituitary gland;
- malfunctions of the endocrine system;
- liver dysfunction;
- the presence of severe cardiovascular diseases.
The latest indications for testing are more related to prophylactic, but for safety reasons, an analysis on GTT is best done.
A significant advantage of glucose tolerance testing is that it can be used to determine the prediabetes state in people at risk (the likelihood of an ailment in them is 15 times higher). If you timely detect the disease and begin treatment, you can avoid undesirable consequences and complications.
Blood for sugar with a load can be taken both from a vein and from a finger
Glucose tolerance tests are indicated for patients with:
- metabolic syndrome;
- atherosclerotic vascular disease;
- high blood pressure (especially with a decompensated course and the appearance of hypertensive crises);
- violation of microcirculation;
- burdened by a family history (the presence of diabetes in close relatives);
- symptoms of diabetes (itching of the skin, dry mucous membranes and skin, constant drowsiness or nervousness, decreased immunity, increased diuresis, weight loss, constant thirst, etc.);
- burdened by obstetric history (infertility, habitual miscarriage, the birth of a large fetus, gestational diabetes mellitus and the development of diabetic fetopathy, late gestosis of pregnancy, the birth of a dead fetus, etc.);
- polycystic ovary syndrome;
- chronic liver pathologies;
- nephropathies or retinopathies of unknown origin;
- persistent pustular diseases of the skin;
- frequent infectious diseases;
- chronic periodontal disease;
- neuropathies of unknown origin;
- acromegaly, etc.
Analysis for the sugar curve during pregnancy is carried out at 24-28 weeks of pregnancy as planned. According to indications, in cases of suspected development of gestational diabetes mellitus, the analysis of the sugar curve during pregnancy can be repeated.
It should be noted that patients from risk groups (persons with impaired glucose tolerance, patients with a burdened family history, women with a history of gestational diabetes mellitus, etc.) should be examined by an endocrinologist once a year (if indicated more often).
Conducting glucose tolerance tests is contraindicated:
- patients under 14 years of age;
- persons with severe injuries, burns, acute infectious and somatic pathologies;
- patients after surgery;
- persons whose fasting sugar exceeds 7.0. mol per liter.
How to take a sugar curve test
Diagnostics for sugar curves can only be carried out in the direction of the attending physician. For routine glucose control, a fasting determination of blood sugar is used.
The glucose dosage for sugar load is calculated individually and depends on the patient’s body weight. 1.75 grams of glucose is prescribed for each kilogram of body weight, however, the total dose of glucose should not exceed 75 grams at a time, regardless of body weight.
Studies that determine the amount of glucose in the blood are prescribed regardless of food and on an empty stomach. Tests are carried out:
- for determining glucose;
- glucose tolerance test (GTT);
- regardless of the meal – glycated hemoglobin.
The rules for preparing a patient for a blood test for fasting sugar from a vein and from a finger are the same.
In order to immediately correctly pass an analysis of fasting sugar, you can’t eat food for 8 to 14 hours before drinking blood, drink drinks such as tea, soda, coffee, juice.
It is allowed, but, nevertheless, it is undesirable to drink even plain still water. The use of any other drinks is strictly prohibited.
The glucose tolerance test is performed first as a routine fasting study. Then, blood sampling is repeated after an hour and after 2 hours.
There is no problem if it is possible to eat if blood is to be donated for glycated hemoglobin, which characterizes the level of sugar 3 months before the procedure.
- to assess hyperglycemic conditions when sugar levels are elevated;
- to detect hypoglycemia when sugar is reduced.
Assignment of tests allows you to identify life-threatening changes in glycemia.
If it is not possible to conduct a test in the morning on an empty stomach, then you can examine the blood for sugar content after 6 hours of fasting, excluding fatty foods from the diet.
Of course, the results of this study cannot be called completely reliable. As soon as possible, you need to properly prepare for the test, and pass a blood test for sugar.
Unlike most other hematological studies, a blood sugar test with a load has a number of limitations for conducting. It is necessary to postpone testing in the following cases:
- with a cold, SARS, flu;
- exacerbation of chronic diseases;
- infectious diseases;
- inflammatory diseases;
- pathological processes in the gastrointestinal tract;
- recent surgical intervention (analysis can be taken no earlier than 3 months).
And also a contraindication to the analysis is taking medications that affect glucose concentration.
Sugar curve: preparation for analysis
The analysis is carried out exclusively on an empty stomach. From the moment of the last meal, at least eight hours should pass. Before taking the test, you can drink boiled water.
Within 3 days prior to the analysis of the sugar curve, it is recommended to follow a normal diet, monitor the sufficient amount of fluid consumed, and also refuse to drink alcohol.
Do not smoke before testing. It is also necessary to limit physical activity and the impact of psychogenic factors.
If possible, after consultation with the doctor, it is recommended that you refuse to take medications that can distort the results of the tests within three days.
An increased glucose level in the analysis can be observed in patients taking thiazide, caffeine, estrogen, glucocorticosteroid drugs, as well as growth hormone drugs.
Low blood sugar levels can occur in individuals undergoing therapy with anabolic steroids, propranolol, salicylates, antihistamines, vitamin C, insulin, and oral hypoglycemic agents.
How to prepare for the analysis
To test showed a reliable concentration of sugar, blood must be donated correctly. The first rule that the patient needs to remember is that blood is taken on an empty stomach, so you can eat no later than 10 hours before the procedure.
And it is also worth considering that the distortion of the indicator is possible for other reasons, so 3 days before testing, you must adhere to the following recommendations: limit the consumption of any drinks that contain alcohol, exclude increased physical activity. 2 days before blood sampling, it is recommended to refuse to visit the gym and pool.
It is important to abandon the use of medicines, to minimize the consumption of juices with sugar, muffins and confectionery, to avoid stress and emotional stress. And also in the morning on the day of the procedure it is forbidden to smoke, chew gum. If the patient is prescribed medication on an ongoing basis, you need to notify the doctor about this.
How is the procedure carried out?
Testing for GTT is pretty easy. The only negative of the procedure is its duration (usually it lasts about 2 hours). After this time, the laboratory assistant will be able to say whether the patient has a failure of carbohydrate metabolism. Based on the results of the analysis, the doctor will conclude how the body’s cells respond to insulin, and will be able to make a diagnosis.
The GTT test is carried out according to the following algorithm of actions:
- early in the morning, the patient needs to come to the medical facility in which the analysis is performed. Before the procedure, it is important to comply with all the rules that the doctor who prescribed the study spoke about;
- the next step – the patient needs to drink a special solution. Usually it is prepared by mixing special sugar (75 g.) With water (250 ml.). If the procedure is performed for a pregnant woman, the amount of the main component can be slightly increased (by 15-20 g.). For children, the glucose concentration changes and is calculated in this way – 1,75 g. sugar per 1 kg of baby weight;
- after 60 minutes, the laboratory technician collects the biomaterial to determine the concentration of sugar in the blood. After another 1 hour, a second sampling of the biomaterial is carried out, after examination of which it will be possible to judge whether a person has a pathology or everything is within normal limits.
If testing is carried out by intravenous glucose, then the procedure will take about 5 minutes. But the primary blood sampling in this case is also carried out after an hour.
The sugar standards in children and adults vary, in women and men they practically do not differ. The value of the concentration of glucose in the blood is affected by whether a person does the test on an empty stomach or after eating.
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The permissible norm of blood sugar in women is 3,5-5,8 mmol / l (the same for the stronger sex), these values are characteristic of the analysis performed in the morning on an empty stomach. The figures shown are correct for taking blood from a finger. Analysis from a vein suggests normal values from 3,7 to 6,1 mmol / L. An increase in indicators to 6,9 – from a vein and to 6 – from a finger indicates a condition called prediabetes.
In some cases, a blood test should be taken immediately, and it is highly likely that the patient has already eaten food. In this case, the norms of blood sugar in adults will vary from 4 to 7,8 mmol / L. Moving from the norm to a smaller or greater side requires additional analysis.
In children, blood sugar rates vary depending on the age of the babies. In newborns, normal values range from 2,8 to 4,4 mmol / L. For children aged 1-5 years, indicators from 3,3 to 5,0 mmol / liter are considered normal. The norm of blood sugar in children over five years old is identical with adult indicators. Indicators in excess of 6,1 mmol / liter indicate the presence of diabetes mellitus.
With the onset of pregnancy, the body finds new ways of working, at first it is difficult to adapt to new reactions, failures often occur, as a result of which the results of many analyzes and tests deviate from the norm. Blood sugar levels differ from normal values for an adult. Blood sugar levels for women awaiting the birth of a child range from 3,8 to 5,8 mmol / liter. Upon receipt of a higher value, the woman is prescribed additional tests.
Sometimes during pregnancy, a state of gestational diabetes occurs. This pathological process occurs in the second half of pregnancy, after the appearance of the baby passes independently. However, if there are certain risk factors after having a baby, gestational diabetes can turn into sugar. In order to prevent the development of a serious illness, it is necessary to constantly take blood tests for sugar, follow the doctor’s recommendations.
Before the test, with a glucometer, an indicator of fasting glucose is assessed. When a result is obtained above 7.0 mmol per liter, a GTT test is not performed, but a simple blood sampling from a vein for glucose is performed.
Upon receipt of a fasting result below 7.0, the patient is given a drink of glucose (the amount depends on the patient’s weight) and the results are evaluated after two hours.
The sugar curve in 2 hours is less than 7.8 mmol per liter.
Upon receipt of results above 7.8, but less than 11.1, an initial diagnosis is made – impaired glucose tolerance.
A result above 11.1 indicates the presence of diabetes in the patient.
Analysis for the sugar curve during pregnancy is carried out in a similar way. After a fasting test, the pregnant woman is given glucose dissolved in 0.3 L of water and the results are evaluated after two hours.
Indicators of the sugar curve in fasting pregnancy:
- below 5.1 in a fasting level – the normal course of pregnancy;
- above 5.1, but less than 7.0 – the development of gestational diabetes is likely;
- above seven – a manifesto of diabetes is likely.
- below 8.5 is the normal course of pregnancy;
- above 8.5, but less than 11.0 – the development of gestational diabetes is likely;
- above 11.1- a likely manifest of diabetes.
Deciphering the result
Deciphering the result and making a diagnosis should be done only by an experienced specialist. The diagnosis is made depending on what will be the glucose readings after exercise. Examination on an empty stomach:
- less than 5,6 mmol / l – the value is within the normal range;
- from 5,6 to 6 mmol / l – prediabetes state. With these results, additional tests are prescribed;
- above 6,1 mmol / l – the patient is diagnosed with diabetes mellitus.
Analysis results 2 hours after consumption of a solution with glucose:
- less than 6,8 mmol / l – lack of pathology;
- from 6,8 to 9,9 mmol / l – prediabetes state;
- over 10 mmol / l – diabetes.
If the pancreas does not produce enough insulin or the cells do not perceive it well, the sugar level will exceed the norm throughout the test. This indicates that a person has diabetes, since in healthy people, after an initial jump, glucose concentration quickly returns to normal.
Even if testing has shown that the component level is above normal, you should not be upset before the time. A test for TGG is always given 2 times to ensure the final result. Usually re-testing is carried out after 3-5 days. Only after this, the doctor will be able to draw final conclusions.
GTT during pregnancy
All representatives of the fair sex who are in position, an analysis for GTT is prescribed without fail and usually they pass it during the third trimester. Testing is due to the fact that during gestation, women often develop gestational diabetes.
Usually this pathology passes independently after the birth of the baby and the stabilization of the hormonal background. To speed up the recovery process, a woman needs to lead a proper lifestyle, monitor nutrition and do some exercises.
Normally, in pregnant women, testing should give the following result:
- on an empty stomach – from 4,0 to 6,1 mmol / l .;
- 2 hours after taking the solution – up to 7,8 mmol / L.
The indicators of the component during pregnancy are slightly different, which is associated with a change in the hormonal background and increased stress on the body. But in any case, the concentration of the component on an empty stomach should not be higher than 5,1 mmol / L. Otherwise, the doctor will diagnose gestational diabetes.
It should be borne in mind that the test is carried out for pregnant women a little differently. Blood will need to be donated not 2 times, but 4. Each subsequent blood sampling is carried out 4 hours after the previous one. Based on the numbers received, the doctor makes a final diagnosis. Diagnostics can be done at any clinic in Moscow and other cities of the Russian Federation.
Causes of Changes in Blood Sugar
Increased glucose levels may indicate:
- an excess of contra-hormonal hormones;
- pathologies affecting the pancreas (pancreatitis, cystic fibrosis, etc.);
- chronic liver disease;
- various nephropathies;
- acute stress;
- severe physical strain;
- myocardial infarction;
- the presence of receptor-insulin receptors.
Also, glucose levels can be increased in chronically smokers.
A decrease in glucose may indicate:
- prolonged starvation, exhaustion, following a low-carb diet;
- impaired carbohydrate absorption in the intestine;
- chronic hepatic pathologies;
- various fermentopathies;
- postnatal hypoglycemia in diabetic fetopathy;
- blood diseases.
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