A*******s
发帖数: 9638 | 1 This case is not that simple as you initially claimed.:)
I agree with the endo that this patient can not be diagnosed DM. I posted
the answer at my very first reply but had it revised because our endo specialist,
like againstwind or newprozac, would hammer me badly, lol
A patient with typical clinical symptoms and abnormal OGTT, or abnormal
fasting glucose, is easy to be diagnosed. For one time abnormal OGTT and
normal HgA1c and normal fasting, I would not diagnose DM, and legally would
not st... 阅读全帖 |
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H*s
发帖数: 1410 | 2 护士说我通过了，cut point 140,
google wiki said:
Screening glucose challenge test
The screening glucose challenge test (sometimes called the O'Sullivan test)
is performed between 24–28 weeks, and can be seen as a simplified version
of the oral glucose tolerance test (OGTT). It involves drinking a solution
containing 50 grams of glucose, and measuring blood levels 1 hour later.[29]
If the cut-off point is set at 140 mg/dl (7.8 mmol/l), 80% of women with GDM
will be detected.[5] If this threshold for furt... 阅读全帖 |
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s*********3
发帖数: 2305 | 3 Don't worry too much. You still have chances to pass teh 3 OGTT.
Even you failed the 3 hour OGTT, most likely you can have your blood sugar
level under good control simply by diet and exercises.
Good luck! |
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r**z
发帖数: 1793 | 4 这个做了同时口服脂质和咖啡因对糖耐量的影响，作者认为能降低糖耐量
J Nutr. 2011 Apr 1;141(4):574-81. Epub 2011 Feb 23.
An oral lipid challenge and acute intake of caffeinated coffee additively
decrease glucose tolerance in healthy men.
Beaudoin MS, Robinson LE, Graham TE.
SourceDepartment of Human Health and Nutritional Sciences, University of
Guelph, Guelph, Ontario N1G 2W1, Canada.
Abstract
Lipid-induced insulin resistance has been investigated primarily with i.v.
infusions, and caffeine-induced insulin resistance, with alkalo... 阅读全帖 |
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p********3
发帖数: 5750 | 5 糖尿病的诊断是根据血糖来诊断（包括随机血糖和/或者空腹）， OGTT是测试糖耐量，
可以看血糖和胰岛功能（分泌Insulin 的量）。
临床上不靠测试Insulin Resistance来判断二型还是一型。 Age Of Onset， 有没有
Ketone， OGTT显示Insulin Level （这里面有很多讲究啦，比如End Stage Of Type2
， Insulin Level也很低， 长期高血糖导致胰岛抑制也可能Insulin Level很低， 但
是临床医生很容易就可以鉴别这些情况，不至于把二型误诊为一型。）。 还有就是成
人迟发性一型糖尿病（LADA， Latent Autoimmune Diebetes Of the Adults), 可以测
试GAD等抗体来鉴别，当然临床表现也有特殊，这需要临床医生根据临床表现判断来
Order这些测试。
总之，临床上不会测试Insulin Resistance。
glucose, |
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e****0
发帖数: 678 | 6 Endometrial hyperplasia types. Risk of cancer treatment
simple 1% Cyclic progestin
complex 3% Cyclic progestin
Simple atypical 8% THA or progestins
Complex atypical 29% THA or progestins
• Prolatinoma and hypothyroidism galactorrhea
• Anesthesia can reduce uterine activity if in the latent phase
• Contraceptive for lactating mother
Progestin-only oral contraceptive
• Pregnancy luteoma
African-ameri... 阅读全帖 |
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c********e
发帖数: 496 | 7 fasting blood sugar above 11.1, DM
below 5.6, rule it out, only between them, go for OGTT. |
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c********e
发帖数: 496 | 8 only heart failure or renal dysfunction are suspected, the 24 hours urine
volume needs to be counted. for DM, simply check your fasting blood sugar,
twice, if higher than 11.1, Dx of DM is confirmed. if between 7.8 - 11.1, go
for OGTT, if lower than 7.8, it is considered to be normal. |
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l*****y
发帖数: 5737 | 9 我记得你上次发过帖的，现在看起来我觉得不是很严重。
1、心脏超声提到的左房增大和左室舒张功能减低，很多老年人都会有一点，可能和高
血压有关，或者是瓣膜功能不全，都不算很严重，射血分数没有写数值，不清楚是为什
么，可能没问题就不写了？
2、有一张生化的单子里血糖是6点多，不知道是不是空腹的血糖，再加上你提到的餐后
血糖11.35，不知道是不是标准的餐后2小时抽的血，如果是的话要注意一下，最好去做
个OGTT糖耐量试验，看看能不能诊断2型糖尿病，糖化血红蛋白目前还可以，在正常范
围内，需要注意控制饮食加强锻炼了。 |
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c*******k
发帖数: 1308 | 10 Maybe your test strips expired? Any number above 200 definitely needs
attention. I think you should order an OGTT and see how it goes. |
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e*********1
发帖数: 311 | 11 I was diagnosed type 2 diabetes when my 2hour ogtt was 260 even though mr
fasting was 90 and a1c was 5.5 |
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p********3
发帖数: 5750 | 12 如果最近在国内做过糖耐量测试（OGTT）， 知道胰岛功能， 自己带了药和血糖仪，
可以自己调整药物，饮食以及运动方式以求控制。 当然如果血糖控制得很差已久， 可能产生胰岛毒性， 也可能需要临时加点其他治疗。具体情况具体分析。 |
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r**z
发帖数: 1793 | 16 看到第三篇 又是不同结论
Diabetologia. 2011 Feb;54(2):320-8. Epub 2010 Nov 3.
Associations between the intake of caffeinated and decaffeinated coffee and
measures of insulin sensitivity and beta cell function.
Loopstra-Masters RC, Liese AD, Haffner SM, Wagenknecht LE, Hanley AJ.
SourceDepartment of Nutritional Sciences, Faculty of Medicine, University of
Toronto, FitzGerald Building, 150 College St, Toronto, ON, Canada.
Abstract
AIMS/HYPOTHESIS: Although protective relationships between coffee
consumption a... 阅读全帖 |
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z********8
发帖数: 818 | 17
FACS analyze adipocyte progenitor and do some functional assays
这种实验没有必要先做的。可能是放到你整个实验的最后那一步。
先是chow diet，检测体重，饮食量，ITT， ogtt or igtt, 血液指标，脂肪含量/体重
，有变化，做个脂肪组织和肝组织的切片看看。有变化再做个能量代谢。
如果chow diet，你的这个ko 小鼠都有变化，那就神了，说明这个基因很强啊。
不管有没有变化，用个High fat diet试试，也许能看出更明显的效果，重复同样的实
验。
如果想做的fancy一点，cross到ob/ob or db/db mice，这个要看你ko mice是什么背景了.
不要用什么STZ之类的。
最后做各种实验，分析机理。
B6j是做metabolism公认的，6n背景，有的reviewer会不认可，当然了B6j是非常容易诱
导成metabolism dysfunction的小鼠了。 |
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l********y
发帖数: 2295 | 18 来自主题: MedicalCareer版 - MTB勘误 发现MTB不少错误。如果哪位已经有的话可否share一下？
没有的话，就在这里更新了，欢迎大家补充。
p380, in the table, trisomy 18, (not trisomy 21) has decreased beta-hCG.
p382, 3hr 100g OGTT, 180 (not 140) at 1h, 140 (not 180) at 3h. |
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l******o
发帖数: 3764 | 19 本人生物wsnv，最近在学习这方面的知识，所以问题可能比较弱智，请各位海涵：
我觉得光用fasting glucose和OGTT， 只能知道一个人是不是diabetes mellitus吧？
是不是还需要做个insulin resistance test，从而进一步确定是type1还是type2？
如果需要的话，临床上一般用什么方法呢？是不是测测fasting insulin & glucose,
然后算算HOMA-IR, HOMA-beta就可以了？还是其他的方法？
还是说不需要考虑insulin resistance的问题？
谢谢大家 |
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p********3
发帖数: 5750 | 20 对了，忘了说了。其实临床上，OGTT测试血糖和胰岛素（或者CPeptide，胰岛素的一个
片段），如果胰岛素量很高，临床意义也就是说这个病人存在胰岛抵抗。 |
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y*****n
发帖数: 367 | 21 我查了一下书。你在做这个三小时的 100g Oral Glucose Tolerance Test(OGTT)之前
需要一晚上的的空腹(水应该可以喝但最好限量)和至少三天的无限制的饮食（至少有
150g的碳水化合物）以及身体活动。受测试的孕妇需避免caffeine & smoking for 12
hours before and during the test.
上网查了一下fast的意思：
fast--abstention from food, or from food and liquid.
祝身体健康！ |
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a*********d
发帖数: 2763 | 22 very good point.
i personally don't really buy that postprandial hypoglycemia (reactive
hypoglycemia)theory, but that's just me, it's still a controversial topic,
some suggest it is just a functional symptom that might have nothing to do
with real hypoglycemia. the only exception is in patients with history of
bariatric surgery.
secondly, OGTT has no role in diagnosing hypoglycemia, 72 hour fasting is
the only way to know for sure if her hypoglycemia is real deal or not. also
keep in mind, gluco... 阅读全帖 |
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n*******c
发帖数: 501 | 23 Very informative.
My thinking is OGTT can be easily done to see if the patient has diabetes.
If yes, we know the hypos may not be true or just reactive, assuming it is
unlikely he has two different pathologies. If normal glucose tolerance, then
those hypers are most likely to be reactive to hypos.
Just saw the post about referral. Can the neurologist refer a patient who
presented to him with peripheral neuropathy to an endocrinologist for
opinion about diabetes? Or it all goes back to the family... 阅读全帖 |
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a*********d
发帖数: 2763 | 24 again, I don't really believe postprandial hypoglycemia in diabetes, unless
it's treatment induced, so I probably won't use OGTT to diagnosis DM at
first place. the diagnosis of hypoglycemia needs to be established first,
this is the most important step, without this, more tests only make things
more complicated and confusing.
as far as referral, it's tricky, PCP might have their own referral base
depending on their contract and insurance net, so the safest thing to do is
let PCP to decide.
thes... 阅读全帖 |
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n*******c
发帖数: 501 | 25 Thanks for the very educational case.
1. Glucose tolerance test should be done properly before we can rely on its
result. It is very important to make sure for days or even weeks before the
test, the patient has not been restricting carbohydrate. Secondly the
patient should be fasted properly (8hrs rule). You would be surprised how
people understand fasting.lol I have had a patient (back in china) who
thought fasting means no meals but fruits doesn't count so she had some
grape before bed...
2.I... 阅读全帖 |
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