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Unveiling the history of the glucose tolerance test: What was the amazing secret discovered in 1923?
With the advancement of modern medical technology, glucose tolerance test (GTT) has gradually become an important tool for diagnosing diabetes and other metabolic diseases. The test has had a profound impact on the medical community since it was first described in 1923, giving us a clearer understanding of how the body processes sugar. And in this historical process, what are the major breakthroughs and discoveries that are worthy of our deep thought and exploration?
Basic concepts of glucose tolerance test
A glucose tolerance test is a medical test that assesses how quickly glucose is removed from the blood by taking a blood sample after glucose is given to the patient. It is commonly used to detect diabetes, insulin resistance, and other related metabolic disorders. In the most common oral glucose tolerance test (OGTT), the patient takes a dose of glucose by mouth and has their blood sugar levels checked two hours later.
History of testing
The glucose tolerance test was first proposed in 1923 by physician Jerome W. Conn. The test is based on 1913 research by A. T. B. Jacobson, which found that carbohydrate intake causes blood sugar fluctuations. This concept later became known as the "Staub-Traugott phenomenon", which revealed the characteristic that normal patients' blood sugar will quickly return to normal levels after ingesting glucose.
Under normal circumstances, after a patient ingests glucose, the initial blood sugar peak will soon drop to the normal range.
Test preparation and procedures
Before the test, patients need to follow some preparation steps. Doctors will advise patients not to restrict carbohydrate intake in the days before the test, and the test must be done on an empty stomach for 8 to 12 hours. The test begins with a baseline blood sample being drawn, followed by a glass of glucose solution containing a measured dose, which the patient is asked to drink within five minutes. Over the next few hours, blood samples are taken periodically to measure glucose and sometimes insulin levels.
Glucose dosage and changes
The World Health Organization (WHO) recommends that the average adult consume 75 grams of glucose during an OGTT. This dose is based on adult weight, but will be adjusted for children. For pregnant women, 50 grams of glucose is usually used for initial screening.
The purpose of this screening is to detect gestational diabetes early and provide necessary treatment and management.
Interpretation of results
Test results will be evaluated based on fasting and two-hour blood glucose values, which should be less than 5.6 mmol/L. If it is between 5.6 and 6.9 mmol/L, it indicates that the patient may be in a pre-diabetic state. On the contrary, if the test result after two hours is 11.1 mmol/L or above, diabetes can be diagnosed.
Testing limitations and future directions
Although the glucose tolerance test is an important diagnostic tool, it does not differentiate between insulin resistance in peripheral tissues and a reduced ability of pancreatic beta cells to produce insulin. However, as scientific research continues to progress, more perfect testing methods may emerge in the future to further improve the accuracy and effectiveness of such tests.
Conclusion
Glucose tolerance test, as a powerful tool for diagnosing metabolic diseases, continues to evolve with the development of medicine. Since 1923, this test has not only given us a deeper understanding of diabetes, but also attracted the attention of many scientific researchers. With the advancement of science and technology, what kind of breakthroughs can we expect for the future application and improvement of this test?
