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Oral glucose tolerance test in children and adolescents: positives and pitfalls.
J Paediatr Child Health. 2004 Nov; 40(11):620-6.JP

Abstract

OBJECTIVES

To describe the glycaemic status (assessed by an oral glucose tolerance test (OGTT)) and associated comorbidities in a cohort of Australian children and adolescents at risk of insulin resistance and impaired glucose homeostasis (IGH).

METHODS

Twenty-one children and adolescents (three male, 18 female) (18 Caucasian, one Indigenous, two Asian) (20 obese, one lipodystrophy) referred to the Paediatric Endocrinology and Diabetes Clinic underwent a 2-h OGTT with plasma glucose and insulin measured at baseline, + 60 and + 120 min. If abnormal, the OGTT was repeated.

RESULTS

The mean (SD) age was 14.2 (1.6) years, BMI 38.8 (7.0) kg/m2 and BMI-SDS 3.6 (0.6). Fourteen patients had fasting insulin levels >21 mU/L. Type 2 diabetes mellitus was diagnosed in one patient, impaired glucose tolerance (IGT) in four patients and impaired fasting glycaemia (IFG) in one patient. Despite no weight loss, only one patient had a persistently abnormal OGTT on repeat testing. Three patients with IGH were medicated with risperidone at the time of the initial OGTT. One patient who had persistent IGT had continued risperidone. The other two patients had initial OGTT results of IGT and diabetes mellitus type 2. They both ceased risperidone between tests and repeat OGTT showed normal glycaemic status.

CONCLUSIONS

Use of fasting glucose alone may miss cases of IGH. Diagnosis of IGT should not be made on one test alone. Interpretation of glucose and insulin responses in young people is limited by lack of normative data. Larger studies are needed to generate Australian screening recommendations. Further assessment of the potential adverse effects of atypical antipsychotic medication on glucose homeostasis in this at-risk group is important.

Authors+Show Affiliations

Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, Australia. louise_conwell@health.qld.gov.auNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15469531

Citation

Conwell, L S., and J A. Batch. "Oral Glucose Tolerance Test in Children and Adolescents: Positives and Pitfalls." Journal of Paediatrics and Child Health, vol. 40, no. 11, 2004, pp. 620-6.
Conwell LS, Batch JA. Oral glucose tolerance test in children and adolescents: positives and pitfalls. J Paediatr Child Health. 2004;40(11):620-6.
Conwell, L. S., & Batch, J. A. (2004). Oral glucose tolerance test in children and adolescents: positives and pitfalls. Journal of Paediatrics and Child Health, 40(11), 620-6.
Conwell LS, Batch JA. Oral Glucose Tolerance Test in Children and Adolescents: Positives and Pitfalls. J Paediatr Child Health. 2004;40(11):620-6. PubMed PMID: 15469531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral glucose tolerance test in children and adolescents: positives and pitfalls. AU - Conwell,L S, AU - Batch,J A, PY - 2004/10/8/pubmed PY - 2005/2/18/medline PY - 2004/10/8/entrez SP - 620 EP - 6 JF - Journal of paediatrics and child health JO - J Paediatr Child Health VL - 40 IS - 11 N2 - OBJECTIVES: To describe the glycaemic status (assessed by an oral glucose tolerance test (OGTT)) and associated comorbidities in a cohort of Australian children and adolescents at risk of insulin resistance and impaired glucose homeostasis (IGH). METHODS: Twenty-one children and adolescents (three male, 18 female) (18 Caucasian, one Indigenous, two Asian) (20 obese, one lipodystrophy) referred to the Paediatric Endocrinology and Diabetes Clinic underwent a 2-h OGTT with plasma glucose and insulin measured at baseline, + 60 and + 120 min. If abnormal, the OGTT was repeated. RESULTS: The mean (SD) age was 14.2 (1.6) years, BMI 38.8 (7.0) kg/m2 and BMI-SDS 3.6 (0.6). Fourteen patients had fasting insulin levels >21 mU/L. Type 2 diabetes mellitus was diagnosed in one patient, impaired glucose tolerance (IGT) in four patients and impaired fasting glycaemia (IFG) in one patient. Despite no weight loss, only one patient had a persistently abnormal OGTT on repeat testing. Three patients with IGH were medicated with risperidone at the time of the initial OGTT. One patient who had persistent IGT had continued risperidone. The other two patients had initial OGTT results of IGT and diabetes mellitus type 2. They both ceased risperidone between tests and repeat OGTT showed normal glycaemic status. CONCLUSIONS: Use of fasting glucose alone may miss cases of IGH. Diagnosis of IGT should not be made on one test alone. Interpretation of glucose and insulin responses in young people is limited by lack of normative data. Larger studies are needed to generate Australian screening recommendations. Further assessment of the potential adverse effects of atypical antipsychotic medication on glucose homeostasis in this at-risk group is important. SN - 1034-4810 UR - https://www.unboundmedicine.com/medline/citation/15469531/Oral_glucose_tolerance_test_in_children_and_adolescents:_positives_and_pitfalls_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1034-4810&date=2004&volume=40&issue=11&spage=620 DB - PRIME DP - Unbound Medicine ER -