Kostopoulou E, Skiadopoulos S, Partsalaki I, Rojas Gil AP, Spiliotis BE. Repetitiveness of the oral glucose tolerance test in children and adolescents. World J Clin Pediatr 2021; 10(3): 29-39 [PMID: 33972923 DOI: 10.5409/wjcp.v10.i3.29]
Corresponding Author of This Article
Eirini Kostopoulou, MD, PhD, Consultant Physician-Scientist, Research Scientist, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Rio, Patras 26504, Greece. irekost@upatras.gr
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. May 9, 2021; 10(3): 29-39 Published online May 9, 2021. doi: 10.5409/wjcp.v10.i3.29
Repetitiveness of the oral glucose tolerance test in children and adolescents
Eirini Kostopoulou, Spyridon Skiadopoulos, Ioanna Partsalaki, Andrea Paola Rojas Gil, Bessie E Spiliotis
Eirini Kostopoulou, Ioanna Partsalaki, Bessie E Spiliotis, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Patras 26504, Greece
Spyridon Skiadopoulos, Department of Medical Physics, School of Medicine, University of Patras, Patras 26504, Greece
Andrea Paola Rojas Gil, Department of Nursing, University of Peloponnese, Tripolis 22100, Greece
Author contributions: Spiliotis BE and Kostopoulou E designed the study; Kostopoulou E, Skiadopoulos S and Partsalaki I participated in the acquisition of data; Skiadopoulos S, Partsalaki I, Rojas Gil AP and Spiliotis BE participated in the analysis and interpretation of data; Kostopoulou E and Skiadopoulos S drafted the initial manuscript; Spiliotis BE and Rojas Gil AP made critical revisions related to intellectual content of the manuscript; all authors approved the final version of the article for publication.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of the University General Hospital of Patras (Greece).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eirini Kostopoulou, MD, PhD, Consultant Physician-Scientist, Research Scientist, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Rio, Patras 26504, Greece. irekost@upatras.gr
Received: December 25, 2020 Peer-review started: December 25, 2020 First decision: January 18, 2021 Revised: January 25, 2021 Accepted: March 7, 2021 Article in press: March 7, 2021 Published online: May 9, 2021 Processing time: 118 Days and 22.9 Hours
Abstract
BACKGROUND
Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive. Furthermore, limited data are available on the reproducibility of the oral glucose tolerance test (OGTT) in children and adolescents who are obese (OB).
AIM
To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.
METHODS
Eighty-one children and adolescents, 41 females, either overweight (OW), OB or normal weight (NW) but with a strong positive family history of type 2 diabetes mellitus (T2DM), were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece. One or two 3-h OGTTs were performed and glucose, insulin and C-peptide concentrations were measured at several time points (t = 0 min, t = 15 min, t = 30 min, t = 60 min, t = 90 min, t = 120 min, t = 180 min).
RESULTS
Good repetitiveness was observed in the OGTT response with regard to T2DM, while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance (IGT) and no repetitiveness with regard to impaired fasting glucose (IFG). In addition, no concordance was observed between IFG and IGT. During the 1st and 2nd OGTTs, no significant difference was found in the glucose concentrations between NW, OW and OB patients, whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs. Also, OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.
CONCLUSION
In mild or moderate disorders of glucose metabolism, such as IFG and IGT, a diagnosis may not be reached using only one OGTT, and a second test or additional investigations may be needed. When glucose metabolism is profoundly impaired, as in T2DM, one OGTT is probably more reliable and adequate for establishing the diagnosis. Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.
Core Tip: In mild or moderate disorders of glucose metabolism, such as impaired fasting glucose and impaired glucose tolerance, a diagnosis may not be reached using only one oral glucose tolerance test (OGTT), and a second test or additional investigations may be needed, whereas when glucose metabolism is profoundly impaired, as in type 2 diabetes mellitus, one OGTT is probably more reliable and adequate for establishing the diagnosis. Also, overweight and obese patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.
