Glucose challenge test

Screening for gestational diabetes mellitus utilizes the oral glucose challenge test. Groups at high risk are African Americans, Native Americans, Asian Americans, Latino Americans, and Pacific Islanders. 

The issue of pharmacy benefits becomes more complicated and challenging to implement as each year passes. Medicare will provide coverage for diabetic supplies of glucose monitors, test strips, and lancets. Diabetic drugs are not covered. The present official status is even difficult for providing a simple answer to drug coverage. 

ADA (American Diabetes Association) does not recommend the use of an oral glucose tolerance test. Consequently the use of ADA-criteria will normally not allow for identification of individuals with IGT or diabetic individuals where only the post-challenge value is abnormal. 

These studies were the first to challenge the concept that the more convenient diagnosis based on fasting glucose values equalises the more complicated diagnosis based on the oral glucose tolerance test. The observations were, however, confirmed by others, and this was the rationale for WHO in... 

Along with the mentioned above methods, metabolic challenge protocols, such as the oral glucose tolerance test, that can uncover early alterations also in lipid metabolism preceding chronic diseases, were developed and are being successfully used for humans, as discussed by Krug et... 

At this point, every patient with altered mental status should receive a challenge with concentrated dextrose, unless a rapid bedside blood glucose test demonstrates that the patient is not hypoglycemic. Adults are given 25 g (50 mL of 50% dextrose solution) intravenously, children 0.5 g/kg (2 mL/kg of 25% dextrose). Hypoglycemic patients may appear to be intoxicated, and there is no rapid and reliable way to distinguish them from poisoned patients. Alcoholic or malnourished patients should also receive 100 mg of thiamine intramuscularly or in the intravenous infusion solution at this time to prevent Wernicke s syndrome. 

A challenge is to manufacture glucose monitors in such a reproducible manner that they do not require calibration. A user expects to add a drop of blood to the test strip and get a reliable reading without first constructing a calibration curve from known concentrations of glucose in blood. Each lot of test strips is highly reproducible and calibrated at the factory. 

Home glucose test strips were able to reach the market two decades before the first continuous glucose monitors. This points to the tremendous challenges faced in the development of CGM. Following the long and colorful development of the technology will make it easier to understand the present systems. 

---