Oral Glucose Tolerance Test

Test Overview

The oral glucose tolerance test (OGTT) measures the body's ability to use a type of sugar, called glucose, that is the body's main source of energy. An OGTT can be used to diagnose prediabetes and diabetes. An OGTT is most commonly done to check for diabetes that occurs with pregnancy (gestational diabetes).

Why It Is Done

The oral glucose tolerance test (OGTT) is done to:

Check pregnant women for gestational diabetes.
Diagnose prediabetes and diabetes.

How To Prepare

Glucose tolerance diagnostic test

To prepare for the glucose tolerance diagnostic test:

Eat a balanced diet that contains at least 150 grams (g) of carbohydrates a day for 3 days before the test. Fruits, breads, cereals, grains, rice, crackers, and starchy vegetables such as potatoes, beans, and corn are good sources of carbohydrates.
Do not eat, drink, smoke, or exercise strenuously for at least 8 hours before your first blood sample is taken.
Tell your doctor about all prescription and nonprescription medicines you are taking. You may be instructed to stop taking certain medicines before the test.

The glucose tolerance diagnostic test may take up to 4 hours. Since activity can interfere with test results, you will be asked to sit quietly during the entire test. Do not eat during the test. You may drink only water during this time.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, or how it will be done. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

How It Is Done

Glucose tolerance diagnostic test

On the day of testing, the following steps will be done:

A blood sample will be collected when you arrive. This is your fasting blood glucose value. It provides a baseline for comparing other glucose values.
You will be asked to drink a sweet liquid containing a measured amount of glucose. It is best to drink the liquid quickly. For the standard glucose tolerance test, you will drink 75 grams or 100 grams.
Blood samples will be collected at timed intervals of 1, 2, and sometimes 3 hours after you drink the glucose. Blood samples may also be taken as soon as 30 minutes to more than 3 hours after you drink the glucose.

Blood test

The health professional taking a sample of your blood will:

Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
Clean the needle site with alcohol.
Put the needle into the vein. More than one needle stick may be needed.
Attach a tube to the needle to fill it with blood.
Remove the band from your arm when enough blood is collected.
Apply a gauze pad or cotton ball over the needle site as the needle is removed.
Apply pressure to the site and then a bandage.

How It Feels

You may find it hard to drink the extremely sweet glucose liquid. Some people feel sick after drinking the glucose liquid and may vomit. Vomiting may prevent you from completing the test on that day.

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

You may feel faint from having several blood samples taken in one day. But the amount of blood taken will not cause significant blood loss or anemia.

Risks

Some people's blood glucose levels drop very low toward the end of the test. But some people feel like their sugar levels are low, when their levels actually are not low. Symptoms of low blood glucose include weakness, hunger, sweating, and feeling nervous or restless. If you develop these symptoms during the test, you may have your sugar level checked quickly with a glucose meter. If your level is very low, the test will be stopped.

There is very little risk of a problem from having blood drawn from a vein.

You may develop a small bruise at the puncture site. You can reduce the risk of bruising by keeping pressure on the site for several minutes after the needle is withdrawn.
In rare cases, the vein may become inflamed after the blood sample is taken. This condition is called phlebitis and is usually treated with a warm compress applied several times daily.

Results

The oral glucose tolerance test (OGTT) measures the body's ability to use a type of sugar, called glucose, that is the body's main source of energy.

Normal

The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

Normal glucose tolerance test values
75 g of glucose	Fasting:	Less than or equal to 100 milligrams per deciliter (mg/dL) or 5.6 millimoles per liter (mmol/L)^{footnote 1}
	1-hour:	Less than 184 mg/dL or less than 10.2 mmol/L^{footnote 2}
	2-hour:	Less than 140 mg/dL or less than 7.7 mmol/L^{footnote 2}

You have prediabetes if the results of your oral glucose tolerance test are 140 to 199 mg/dL (2 hours after the beginning of the test).

But with screening for gestational diabetes in pregnant women, the American Diabetes Association has recommended specific glucose values be used for diagnosis.

Glucose tolerance diagnostic test (for gestational diabetes)^{footnote 3}
		Values that indicate gestational diabetes.
75 g of glucose	Fasting:	More than or equal to 92 mg/dL or 5.1 mmol/L
	1-hour:	More than or equal to 180 mg/dL or 10.0 mmol/L
	2-hour:	More than or equal to 153 mg/dL or 8.5 mmol/L
100 g of glucose	3-hour:	More than or equal to 140 mg/dL or 7.8 mmol/L

High values

High glucose levels may be caused by:

Diabetes.
Gestational diabetes.
Hyperthyroidism.
Some medicines, such as corticosteroids, niacin, phenytoin (Dilantin), some diuretics, and some medicines used to treat high blood pressure, HIV, or AIDS.
Large amounts of the hormone cortisol in the blood (Cushing's syndrome).
Inherited diseases, such as hemochromatosis.
Pheochromocytoma.

Low values

Low glucose levels may be caused by:

Certain medicines, such as medicines used to treat diabetes, some blood pressure medicines (such as propranolol), and some medicines for depression (such as isocarboxazid).
Decreased production of the hormones cortisol and aldosterone (Addison's disease).
Problems with the thyroid gland or an underactive pituitary gland.
A tumor or other problems of the pancreas.
Liver disease.

Many conditions can change blood glucose levels. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

Smoking.
Alcohol.
Recent surgery, illnesses, and infectious diseases.
Weight loss through dieting.
Long periods of bed rest (such as from a hospitalization or illness).

What To Think About

When screening for gestational diabetes, a test might be done before the 100-gram oral glucose tolerance test (OGTT). For the first test, you will not need to fast. You will drink 50 grams of glucose. Your blood sample will be taken 1 hour later. If your glucose level is high-for example, over 140 mg/dL (7.8 mmol/L)-you will be asked to take the second test, the 100-gram OGTT.

Even though your gestational diabetes will probably go away after your baby is born, you are at risk for gestational diabetes if you become pregnant again and for type 2 diabetes later in life. You may also have a follow-up glucose tolerance test 4 to 12 weeks after your baby is born or after you stop breastfeeding your baby. If the results of this test are normal, you will still need to be screened for diabetes at least every 3 years.

References

Citations
American Diabetes Association (2017). Standards of medical care in diabetes-2017. Diabetes Care, 40(Suppl 1): S1-S135. http://care.diabetesjournals.org/content/40/Supplement_1. Accessed December 15, 2016.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
American Diabetes Association (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37(Suppl 1): S81-S90. DOI: 10.2337/dc14-S081. Accessed April 27, 2017.
Other Works Consulted
American Diabetes Association (2017). Standards of medical care in diabetes-2017. Diabetes Care, 40(Suppl 1): S1-S135. http://care.diabetesjournals.org/content/40/Supplement_1. Accessed December 15, 2016.
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.

Credits

ByHealthwise Staff

Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine

Kathleen Romito, MD - Family Medicine

Adam Husney, MD - Family Medicine

Specialist Medical ReviewerMatthew I. Kim, MD - Endocrinology

David C.W. Lau, MD, PhD, FRCPC - Endocrinology

Current as ofJune 1, 2017

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Current as of: June 1, 2017

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Matthew I. Kim, MD - Endocrinology & David C.W. Lau, MD, PhD, FRCPC - Endocrinology