Vergleichende Untersuchungen mit der oralen und intravenösen Glucosebelastung zur Erfassung einer verminderten Kohlenhydrattoleranz

Abstract

Oral (o.GTT) and intravenous glucose tolerance tests (i.v. GTT) were carried out on 492 patients of both sexes, aged from 5 to 78 years. Three hundred and fifty-nine non-diabetics in all were suspected clinically of reduced carbohydrate tolerance leaving 133 patients for comparison (controls). In 102 obesity was noted, 221 had a family history of diabetes and 36 had experienced complications with previous pregnancies. Patients were divided into two groups: i.e. below and above 40 years of age and subdivided again according to normal weight or obesity. At the oral test 100 g glucose was given and the blood sugar determined every 30 min for 180 min. The intravenous test was performed according toCONARD's method(5). Age did not affect the glucose tolerance test in the healthy patient (controls), and following oral or intravenous tests no appreciable difference was noted between the younger and older groups, apart from the 60 min oral estimation; the average age of the older group, however, being relatively low at 54 years. Both groups together showed a general upper biological limit (mean value + 2s D ). The oral tests in patients below 40 years of age with accompanying slight obesity, in patients with a family history of diabetes and in patients of normal weight with complications in previous pregnancies, showed no appreciable difference from those of the corresponding age groups of normal weight; yet the intravenous test was significantly different in all groups concerned. In the case of patients of the same age but with gross obesity (more than + 30% according to Broca), in patients with a family history of diabetes with accompanying obesity and in obese patients with complications in previous pregnancies, significantly abnormal curves were found with the oral as well as i.v. test. In the same groups, above the age of 40 years, in comparison with controls of normal weight and corresponding age, the curves of the oral as well as intravenous tests were significantly different and became more so when gross obesity was present or other symptoms were combined with obesity. In patients clinically suspected of impaired glucose tolerance the carbohydrate tolerance became poorer with increasing age and obesity. According to our observations it would appear simpler to elicit a reduced glucose tolerance with the i.v. method than with the oral test.