Related Experiment Videos
Diagnostic value of disaccharide tolerance tests in children
Insights
Oral disaccharide tolerance tests for children have limited diagnostic accuracy. Direct intra-intestinal administration with a 20 mg/100 ml blood glucose rise within one hour reliably identifies disaccharide malabsorption.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Diagnostics
Background:
- Oral disaccharide tolerance tests are commonly used to diagnose malabsorption in children.
- Previous studies suggested potential limitations in the diagnostic accuracy of these tests.
Purpose of the Study:
- To evaluate the diagnostic value of oral lactose and sucrose tolerance tests in pediatric patients.
- To compare oral test results with direct intra-intestinal administration and small intestine biopsy findings.
Main Methods:
- 105 oral lactose and sucrose tolerance tests were performed on 61 children.
- In cases of low blood sugar rise, direct intra-intestinal disaccharide instillation was used as a control (40 cases).
- Blood glucose response was correlated with disaccharidase activity from small intestine biopsies (21 patients).
Main Results:
- Oral lactose tests showed 23-30% false-positive rates; oral sucrose tests showed 24-33% false-positive rates.
- A direct intra-intestinal glucose rise of 20 mg/100 ml within one hour effectively distinguished between patients with and without disaccharide malabsorption.
- Blood glucose measurements beyond one hour post-administration lacked diagnostic value.
Conclusions:
- Oral disaccharide tolerance tests exhibit significant false-positive rates in children.
- Direct intra-intestinal administration with a specific glucose rise threshold is a more reliable diagnostic method for disaccharide malabsorption.
- Standard oral tolerance tests may require re-evaluation for their clinical utility in pediatric diagnostics.
Abstract:
Diagnostic value of disaccharide tolerance tests in children. Acta Paediatr Scand, 64:693, 1975.--The diagnostic value of oral lactose and sucrose tolerance tests was investigated in 61 children. A total of 105 oral disaccharide tests were carried out. When the rise in blood sugar was low, the same disaccharide was, as a control measure, instilled directly into the small intestine through a tube. This was carried out in 40 cases. In 21 patients the rise in blood sugar following the two forms of administration was correlated with the disaccharidase activity in a peroral small-intestine biopsy. The incidence of false-positive oral lactose tests was between 23 and 30%, that of false-positive oral sucrose tests between 24 and 33%. A border value of 20 mg per 100 ml in the rise of blood glucose within the first hour following a direct intra-intestinal administration affords a very satisfactory distinction between patients with and without disaccharide malabsorption. Blood glucose determinations exceeding one hour were found to be without diagnostic value.