glucose, postprandial (2-Hour postprandial glucose [2-Hour PPG], 1-Hour glucose screen)
المؤلف:
Kathleen Deska Pagana, Timothy J. Pagana, Theresa Noel Pagana.
المصدر:
Mosbys diagnostic and laboratory test reference
الجزء والصفحة:
15th edition , p467-468
2025-05-11
565
Type of test
Blood
Normal findings
2-Hour PPG
0-50 years: < 140 mg/dL or < 7.8 mmol/L (SI units)
50-60 years: < 150 mg/dL
60 years and older: < 160 mg/dL
1-Hour glucose screen for gestational diabetes < 140 mg/dL
Test explanation and related physiology
For this study, a meal acts as a glucose challenge to the body’s metabolism. Normally, insulin is secreted immediately after a meal in response to the elevated blood glucose level, causing the level to return to the premeal range within 2 hours. In patients with diabetes, the glucose level usually is still elevated 2 hours after the meal. The PPG is an easily performed screening test for diabetes mellitus. If the results are greater than 140 mg/dL and less than 200 mg/dL, a glucose tolerance test (GTT, p. 469) may be performed to confirm the diagnosis. If the 2-hour PPG is greater than 200 mg/dL, a diagnosis of diabetes mellitus is confirmed.
The 1-hour glucose screen is used to detect gestational diabetes mellitus (GDM). Screening for GDM is performed with a 50- to 100-g oral glucose load followed by a glucose level determination 1 hour later. This is called the O’Sullivan test. Screening is done between weeks 24 and 28 of gestation. However, patients with risk factors such as a previous history of GDM may benefit from earlier screening. Patients whose serum glucose levels equal or exceed 140 mg/dL may be evaluated by a 3-hour glucose tolerance test. A 100-g oral glucose load is indicated for the diagnosis of gestational diabetes when results of the 50-g oral glucose load 1-hour screening test result are abnormal.
Interfering factors
• Stress can increase glucose levels.
• If the patient is not able to eat the entire test meal or vomits some or all of the meal, levels will be falsely decreased.
Procedure and patient care
• See inside front cover for Routine Blood Testing.
• Fasting: yes • Blood tube commonly used: red or gray
* For the 2-hour PPG, instruct the patient to eat the entire meal (with at least 75 g of carbohydrates) and then not to eat anything else until the blood is drawn.
• For the 1-hour glucose screen for GDM, give the fasting or non-fasting patient a 50-g oral glucose load.
* Instruct the patient not to smoke during the testing. Smoking may increase glucose levels.
* Inform the patient that he or she should rest during the 1- or 2-hour interval.
Abnormal findings
Increased levels
- Diabetes mellitus
-Gestational diabetes mellitus
-Malnutrition
-Hyperthyroidism
-Acute stress response
-Cushing syndrome
-Pheochromocytoma
-Chronic renal failure
-Glucagonoma
-Diuretic therapy
-Corticosteroid therapy
-Acromegaly
-Extensive liver disease
Decreased levels
- Insulinoma
-Hypothyroidism
-Hypopituitarism
-Addison disease
-Insulin overdose
-Malabsorption or maldigestion
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