D-solve - Solve Diabetes Using Low Carb & Low Insulin Diabetes Management

This information is taken from http://hypoglykemie.nl/gtt.htm

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INTRODUCTION

The oral glucose tolerance test (OGTT or GTT ) is a diagnosis method for diabetes and reactive hypoglycemia. In short, the GTT consists of drinking a 100g glucose solution and measuring the blood glucose (bG) values every hour to get a curve. The form of the curve tells us a lot about the body's sugar metabolism. A normal (2 hour) GTT is sometimes used to diagnose diabetes, however, this is not a common practice anymore. In order to diagnose reactive hypoglycemia an extended (5 or 6 hour) test is necessary, as with some hypoglycemics symptoms won't occur until the 5th hour.

These days, the GTT is not considered as the instrument for the diagnosis of reactive hypoglycemia anymore, because if one looks at blood glucose (bG) values only quite some healthy persons would be recognised as hypoglycemics too. Twenty-five percent of the normal population will have hypoglycemic symptoms and a blood glucose content less than 50 mg/dL (2.8 mmol/l) when challenging a GTT. Many have blood glucose levels less than 50 mg/dL but remain asymptomatic. Therefore, not only the bG values are of importance, hypoglycemic symptoms must be experienced in the course of the test in order to diagnose someone as a hypoglycemic.

It is not my advice to try this at home. Because of the severe symptoms that may occur during the test (100 g of glucose is a hell of a load) a GTT is normally carried out in hospital. With the help of a glucometer it may also be carried out in any other clinic, though (handheld finger prick) glucometers are not as accurate as laboratory tests on whole blood samples. In case of fast bG level change, psychotic or neurotic behaviour might be present during the test. Especially patients who take cortico-steroids, the birth control pill, diuretics, salicates (Asperin) or fenytoine (anti-epilepticum) are strongly discouraged to try this at home.
 
 

INSTRUCTIONS

Some instructions on how a normal GTT (used in diagnosing diabetes) is carried out. At least three days before the test a diet rich in carbohydrates has to be followed (230-300 grams per day). During the test, no eating or smoking is permitted. The diabetes test lasts for 3 hours.

As said, this test is not suitable to diagnose reactive hypoglycemia with, because low blood sugar levels as a reaction on the glucose intake often occur after 2 hours or more (up to 5 or 6 hours). Therefore, Harris proposed a 6-hour test with 1-hour interval samples. It is advisable to take additional samples at 0.5 and 3.5 (steep curve-slopes are likely to be seen at these times in case of reactive hypoglycemia) and whenever the patient experiences symptoms. No meals after 20.00h on the day before the test. For the sake of accuracy it is recommended to stop any medication (if possible!) a few days before the test, because of their potential influence on the blood glucose metabolism. Nutritional supplements may influence the test results as well.

It is noted, that the given ranges in the curve that is considered normal (below) are an average. The patient's symptoms are just as important as the actual GTT curve.
 
 

GTT CURVES

With all of the following curves, 100 g of glucose (solution in water) is taken at the start of the test. The average blood glucose level at which urinal glucose is found is 170 mg/dl. This may be an indication for diabetes. All of the tests lasted for 6 hours, with blood samples being taken at 30 min, 1 h, 2 h...6 h. To convert the blood glucose level values in mg/dl to mmol/l, divide by factor 18. The presented curves are used in diagnosing several blood sugar metabolism disorders. It is obvious that real curves may vary from person to person (and even from month to month). If the measured values lie within the ranges of the following 'normal curve' and no typical symptoms are present good glucose tolerancy is allowed to be concluded.

Some typical GTT curves may look as follows:
 

Early diabetes	normal fasting glucose, glucose high during the first 2 hours indicating diabetes, lowplasma glucose hours 3 to 4
Postgastrectomy	rapid elevation of glucose by 1 hour, rapid decline with a trough at 2 to 3 hours
Idiopathic hypoglycemia	normal plasma glucose hours 1 and 2, low glucose hour 3, return to baseline by hour 5
Idiopathic postprandial syndrome	have postprandial adrenergic symptoms with normal GTT

More detailed info can be found below, and at these sites: Stop-Don't-Shoot site, Healthgate Database.
 

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INDEX
 

1. Normal curve  2. Mild diabetes  3. Severe diabetes  4. Continuous low  5. Pre-hypoglycemia

6. Mild hypoglycemia  7. Severe hypoglycemia I  8. Severe hypoglycemia II  9. Flat curve  10. Diabetes and hypoglycemia

Note: 18 mg/dl = 1 mmol/l, so to convert (US) mg/dl to (European) mmol/l simply divide by a factor 18.

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1. Normal curve according to Seale Harris

Time [hours]	0	0.5	1	2	3	4	5	6
bGmin [mg/dl]	80	90	105	90	80	80	80	80
bGmax [mg/dl]	120	135	160	130	110	100	110	105

 

2. Curve with mild diabetes (Source: Hypoglycemia, Dr. P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	115	145	180	160	120	130	130	130

 

3. Curve with severe diabetes (Source: Hypoglycemia, Dr. P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	200	235	265	280	300	295	280	270

 

4. Continuous low values (Source: Orthomoleculair, 3, 1988, G.E. Schuitemaker, in Dutch)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	60	80	100	60	60	60	60	55

The curve stays under normal levels during the entire test. A rare tumor, called insulinomia, may be the cause. In hospitals, a 3-hour GTT is used in diagnosis.
 
 

5. Pre-hypoglycemia (Source: Hypoglycemia, P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	90	115	140	100	85	80	70	75

The curve is typical for a prestage of hypoglycemia. However, a range of mild symptoms may be present at this stage. A 3-hour GTT would not have been long enough to diagnose this type of hypoglycemia.
 
 

6. Mild hypoglycemia (Source: Hypoglycemia, P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	80	120	80	60	80	75	80	80

This curve represents a mild form of hypoglycemia. Within the hour, the bG level drops to normal value. During the second hour, the value is far too low, this is typical in case of reactive hypoglycemia. Consequently, the curve rises until the normal value are reached. Because the bG level drops 40 mg% (mg/dl) within half an hour, severe symptoms may occur.
 
 

7. Severe hypoglycemia I (Source: Hypoglycemia, P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	95	110	120	105	100	60	40	60

During the first 3 hours, the curve is fully normal. However, this curve depicts a form of hypoglycemia that often occurs and causes severe symptoms. The fact that the curve drops more than 20 mg% (mg/dl) below normal value indicates already that severe symptoms might well possible be present.
 
 

8. Severe hypoglycemia II (Source: Hypoglycemia, the disease your doctor won't treat; Saunders, Ross)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	100	170	110	130	170	125	100	100

This 'sawtooth-curve' indicates a severe form of hypoglycemia, though values do not actually drop below normal values. However, severe symptoms may occur.
 
 

9. Flat curve (Source: Hypoglycemia; P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	90	90	90	100	90	100	80	90

This is a flattened glucose tolerance curve. This curve may be characteric for people who conduct a dull, monotonous life. They complain about chronic fatigue, boredom, disinterest and loss of libido.
 
 

10. Diabetes and hypoglycemia (Source: Hypoglycemia; P. Airola)

Time [hours]	0	0.5	1	2	3	4	5	6
bG [mg/dl]	100	160	220	160	85	60	50	85

This is a curve of a patient that is both diabetic and hypoglycemic. With such a curve, severe symptoms are likely to be expected, e.g. asthma.

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