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Related Experiment Videos

Poor reliability of the first meal tolerance test.

R L Bijlani1, J P Narain, K Shukla

  • 1Department of Physiology and Food Science Laboratory, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Physiology and Pharmacology
|October 1, 1992
PubMed
Summary

The first oral glucose tolerance test (OGTT) may show higher blood sugar levels in healthy individuals due to apprehension. Repeating the test is recommended for accurate diagnosis, especially in borderline cases.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Clinical Diagnostics

Background:

  • The oral glucose tolerance test (OGTT) is known for poor reproducibility.
  • Recent studies suggest higher initial postprandial glucose levels during the first test occasion.

Purpose of the Study:

  • To investigate if postprandial glycemia is higher on the first occasion compared to subsequent visits using meal tolerance tests (MTT).
  • To assess the reliability of a single OGTT or MTT as a diagnostic tool.

Main Methods:

  • Analyzed data from meal tolerance tests (MTTs) in 15 healthy subjects and 9 subjects with non-insulin-dependent diabetes mellitus (NIDDM).
  • Subjects underwent two identical meal tests one to two weeks apart.

Main Results:

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  • Healthy subjects showed significantly higher absolute and incremental postprandial glycemia at 0.5h and 1.0h on the first visit (P < 0.05).
  • This effect was not significant in NIDDM subjects.
  • The difference in healthy subjects may be attributed to apprehension-induced adrenaline release.

Conclusions:

  • A single casual OGTT or MTT is unreliable for diagnosing borderline impaired glucose tolerance.
  • Repeating the test is crucial to eliminate false positives and ensure diagnostic accuracy.