Use of a physiologic oral glucose solution for screening for impaired glucose tolerance and non-insulin-dependent diabetes mellitus

Objective.-To evaluate a lower osmolar, more physiologic oral glucose solution as part of an oral glucose tolerance test and to compare it to the standard glucose solution to see if it could serve as an effective screening agent for patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus. Methods.-A total of 100 subjects were given both the standard (1.38 mol/L) 75-g oral glucose tolerance test solution and the lower osmolar (0.62 mol/L) 50-g glucose solution. Each test was separated by at least 3 days. Blood samples were drawn at baseline and 30, 60, and 120 minutes after ingestion of each glucose solution. The 1- and 2-hour blood glucose values obtained using the 75-g oral glucose tolerance test beverage were used as the gold standard to diagnose diabetes according to World Health Organization criteria. Results.-Both solutions were shown to have a high sensitivity and specificity for detecting diabetes and impaired glucose tolerance at 30 and 60 minutes. Conclusions.-The physiologic 50-g solution uses less glucose, is highly palatable, and is similar in sweetness and carbohydrate concentration to commonly consumed soda beverages. A larger study including more patients with impaired glucose tolerance will need to be performed to verify our conclusions. The ability to perform high-sensitivity and high-specificity screening for patients with diabetes or impaired glucose tolerance with a single timed blood sample could make mass screening more practical.