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Oral Glucose Tolerance Test

Oral Glucose Tolerance Test

Detail information about Oral Glucose Tolerance Test.
Here we discuss about the type, indications, contra-indications, precautions, Medication avoiding, Nursing care plan, Risks of OGTT & explain the technique, procedures of doing the test. Thus OGTT is a very important test in medical field. Upgrade your knowledge by reading this. Thanks.

Detail information about Oral Glucose Tolerance Test.
Here we discuss about the type, indications, contra-indications, precautions, Medication avoiding, Nursing care plan, Risks of OGTT & explain the technique, procedures of doing the test. Thus OGTT is a very important test in medical field. Upgrade your knowledge by reading this. Thanks.

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Oral Glucose Tolerance Test

  1. 1. WELCOME
  2. 2. Topic: Urine for Sugar Test
  3. 3. Introduction Glucose is a type of sugar getting from foods we eat and our body uses it for energy. When we eat carbohydrate such as sugar or sucrose, our body digest it into glucose, a simple sugar that can easily be convert into energy. The glucose go straight from the digestive system into the bloodstream after food is consumed and digested. But glucose can only enter cells if there is insulin in the bloodstream too. A glucose tolerance test measures how well the body’s cells are able to absorb glucose after consuming a specific amount of sugar. The glucose tolerance test is the most sensitive test for detecting borderline DM. Glucose tolerance means the ability of the body to utilize glucose in the circulation. Thus “OGTT” is a valuable diagnostic aid in diagnosis of DM, insulin resistance, impaired B-cell functioned relative hypoglycemia and acromegaly.
  4. 4. Definition OGTT means “Oral Glucose Tolerance Test”. It is a laboratory test to diagnose DM(Diabetes Mellitus). In this test, glucose is administered to a person orally and blood glucose levels are measured at regular interval & interpretation is done between blood glucose levels with various disorders associated with carbohydrate metabolism.
  5. 5. Types of OGTT Standard OGTT: A 2 hour 75gm oral glucose tolerance test is used to tests for diabetes. A fasting blood sample is collected before to test glucose level. I/V glucose tolerance test: Test is taken for malabsorption patients. Mini glucose tolerance test: As per WHO, here 2 samples are collected, fasting and 2 hours post glucose load.
  6. 6. Purposes of OGTT Screening & diagnosis of pre-diabetes or impaired glucose tolerance. Screening & diagnosis of type-ll diabetes. Screening for GDM(Gestational Diabetes Mellitus). Reactive hypoglycemia. For detection of B-cell dysfunction.
  7. 7. Importance  To find out the ability of the body to cabohydrate metabolism.  To detect: 1. DM 2. Endocrine function. 3. Renal glycosuria. 4. Alimentary glycosuria.
  8. 8. Indications Patients with family history of diabetes. Massive obesity. H/O recurrent infection. Patients with delayed healing of wounds. Women who have H/O stillbirth, premature birth or large baby. Patients with transient glycosuria or hyperglycosuria during pregnancy.
  9. 9. Contraindications In proven case of DM. OGTT is required only id doubtful cases, it is not recommended for follow up of patients. The test should not be carried out in acutely ill patients.
  10. 10. Complications Infection, if the area is not properly sterilized before the sample is taken. Excessive bleeding from the area. Bruising & swelling. Feeling light headedness.
  11. 11. Precautions The patients is instructed to eat good carbohydrate diet for 3 days prior to the test. Diet containing about 35- 50gm of carbohydrate should be taken. The patient should avoid certain drugs for at least 2 days prior to the test. The patients should abstain from smoking. Stressful exercise is to be avoided prior to test. Exercise is to be avoided also.
  12. 12. Medications that should be avoided Diuretics (thiazide specially) Corticosteroids Synthetic estrogen Phynetoin (Dilantin)
  13. 13. Advantages The OGTT is considered the most effective way to determine in case of GDM. Managing sugar level decrease the chances of baby growing larger for dates. Managing sugar level may decrease the risk of intervention in labour & birth.
  14. 14. Disadvantages It is a time consuming test. Test result may be influenced by stress, illness or medications. Blood is less stable after collection due to improper handling or storage of blood.
  15. 15. Risks of OGTT These tests have no serious risks. It has some risks include- Nausea Stomach discomfort Diarrhea Constipation Bloating Headache
  16. 16. Patients preparation for OGTT  Normal diet for 3-5days.  Diet containing about 30-50gm of carbohydrate should be taken on the evening before the test.  Certain should be avoided.  To remain fasting overnight.  Avoid going bathroom before test as urine sample may be needed.  75gm glucose is to be administered.  Avoid smoking.
  17. 17. Procedures Equipment's: 1. Tray with cover. 2. Sterile kidney tray. 3. Cotton swab. 4. Spirit. 5. Oxalated test tube. 6. Glucose 75gm. 7. Water. 8.Test tube. 9. Specimen label.
  18. 18. Explain about the test to the patient. Instruct the patient to maintain a high carbohydrate diet for 3 days. 75gm glucose in 250-300ml water is given by mouth. Venous blood sample & urine samples are collected either at the end of 2 hours or at half hourly intervals for 2-3 hours. Inform the patient that she/he may feel a slight discomfort due to needle puncture. Plasma glucose is estimated on each sample.
  19. 19. Results: 1. Normal OGTT: Serum glucose values in all samples are within normal range. 2. Impaired glucose tolerance: Fasting- 5.5- 7 mmol/L Postprandial glucose- 7.8- 11.1 mmol/L
  20. 20. 3. Renal glycosuria: Blood glucose normal but sugar present is urine. 4. Alimentary glycosuria: Fasting sugar level is normal. Half/one hourly glucose is threshold. Glucose level rises and falls sharply. 5. Diabetes criteria: Blood glucose Normal(mmol/L) DM(mmol/L) Fasting <5.5 ≥7 2 hrs after 75gm glucose <7.8 ≥11.1
  21. 21. Nursing care plans Diagnosis Goal Interventions Evaluation Risk for light headedness To prevent light headedness 1. Advise to drink more water & low salt diet. 2. Gibe antiemetic drug. 3. Lying down with closed eyes in quiet room. 4. Eat healthy diet. Gradually relief from light headedness. Risk for infection To prevent infection 1. Assess vital sign 4 hourly. 2. Maintenance of aseptic techniques. 3. Gently handling the patient. 4. Antibiotic may be given. Risk of infection sub-sided.
  22. 22. Deficit knowledge about OGTT Provide information about OGTT 1. Assess the patients knowledge about OGTT. 2. Give general knowledge about OGTT & its importance. 3. Teach about normal range. 4. Advise to report any abnormal sign. Adequate knowledge about OGTT
  23. 23. Summery Though OGTT is time consuming still considered as the Gold standard for diagnosing Diabetes Mellitus or rest of the indications are negative. OGTT evaluates the efficiency of the body to metabolize glucose. Depending on the baseline data doctor may recommend changes medication or treatment. Consulting with health care providers about any concerns regarding follow up care & instructions.
  24. 24. Thanks

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