Система Orphus

Symptoms of disease - impaired glucose tolerance

At the present time it is established, that impaired glucose tolerance is an early risk factor for developing type 2 diabetes, as well as a formidable in its downstream of the metabolic syndrome. The main complication of the metabolic syndrome is the development of cardiovascular diseases (hypertension and myocardial infarction), leading to premature death. It is known that the probability of the development of the pathology of the coronary vessels in diabetes mellitus in 2-4 times higher than in the General population, and 50-75% of patients with diabetes die from heart attack of a myocardium.

As impaired glucose tolerance is an early risk factor for cardiovascular disease and type 2 diabetes, the glucose tolerance test should be the same obligatory procedure for every man, as the measurement of the arterial blood pressure.

The holding of glucose-tolerance test allows to detect the patients, which in the future may suffer serious illnesses in advance to give recommendations for their prevention and thus preserve their health and prolong life years.

Usually type 2 diabetes there are three main stages of development: pre-diabetes (reliable risk groups), impaired glucose tolerance (latent diabetes mellitus) and a clear diabetes. As a rule, at the beginning of the patients is not a «classic» signs of the disease (thirst, weight loss, excessive urine).

The asymptomatic type 2 diabetes explains the fact that specific to diabetes complications such as retinopathy and nephropathy, are identified in 10-15% of patients already in the primary diagnosis of the disease. In the practice of identifying the threat of developing diabetes it is possible at the stage of violations of tolerance to glucose.

Which diseases there is impaired glucose tolerance

Absorption in the blood glucose stimulates the secretion of insulin the pancreas, which leads to the absorption of glucose tissues and a decrease in blood glucose level after 2 h after load. In healthy people, the level of glucose in 2 hours after glucose load is less than 7,8 mmol/l, in people with diabetes - more than 11.1 mmol/l. Intermediate values is identified as impaired glucose tolerance or «pre-diabetes».

Impaired glucose tolerance is due to the combined violation of the secretion of insulin and reduced sensitivity of tissues (high resistance) to insulin. The level of glucose in violation of glucose tolerance may be normal or slightly increased. The part of the people with impaired glucose tolerance it can later recover to normal in approximately 30% of observations), but this state can be maintained, and in people with impaired glucose tolerance there is a high risk of increasing violations of carbohydrate metabolism, and the transition of these violations in type 2 diabetes.

Impaired glucose tolerance, in addition, often caused by a complex of interrelated risk factors of cardiovascular diseases (high blood pressure, high cholesterol and high level of low density lipoprotein, low cholesterol lipoproteins of high density), which is defined as the «metabolic syndrome» or the «syndrome of insulin resistance,» or «syndrome X». In case of violation of tolerance to glukoze certain measures can help prevent the buildup of disorders of carbohydrate metabolism: increased physical activity, decreased body weight (body mass index), a healthy balanced diet.

The test is inappropriate conduct in repeatedly confirmed the level of glucose higher diagnostic threshold diabetes (of 7.0 mmol/l). His conduct is contraindicated in persons, in which the concentration of glucose more than 11.1 mmol/l, and also have suffered in the recent past surgery, myocardial infarction, childbirth. At the discretion of the doctor, if necessary, the test can be undertaken in parallel with the definition of the level of C-peptide fasting and 2 hours after glucose load to determine the secretory provision of insulin.

In the group of people with a risk of developing diabetes, requiring examination and compulsory test for tolerance to glukoze, include:
- close relatives of patients with diabetes;
people with overweight (BMI >27 kg/m2);
- women who have had miscarriages, premature birth, birth dead or large fruit (more than 4.5 kg);
mothers of children with development defects;
- women in which in the period of pregnancy was gestational diabetes mellitus;
- people who suffer from arterial hypertension (>140/90 mm Hg.);
- the person with the level of cholesterol - high density lipoproteins > of 0.91 mmol/l;
- people with triglyceride levels reaches of 2.8 mmol/l;
people with atherosclerosis, gout and hyperglycaemia;
- persons with episodic glycosuria and hyperglycaemia, reveling in stressful situations (surgery, trauma, disease);
- people with chronic diseases of the liver, kidneys, cardiovascular system;
- the person with the manifestations of metabolic syndrome (insulin resistance, hyperinsulinemia, - dyslipidemia, hypertension, giperuriquemia, increased platelet aggregation, the androgenic obesity, polycystic ovaries);
- patients with chronic periodontitis and furunculosis;
- persons with neuropathies unclear etiology;
- persons with spontaneous hypoglycemia;
patients receiving long-term diabetogenic drugs (synthetic estrogens, dioretiki, corticosteroids, etc.);
- healthy people over 45 years of age (it is advisable to be screened at least once in two years).

All the people who are in the risk group, it is necessary to determine the tolerance to glukoze, even if the levels of glucose in the blood prandial are in the normal range. In order to avoid the mistakes of the study should be two-fold. In doubtful cases it is necessary to test the tolerance to glukoze with intravenous glucose.

Considering all the above, it becomes obvious that the problem of control of blood glucose is important in practice, endocrinologist, cardiologist, neurologist, General practitioner.

In carrying out glucose-tolerance test should be observed the following terms and conditions:
- the subjects for a period of not less than three days before the tests should comply with the normal operation of the power supply (with a carbohydrate content > 125-150 g / day) and to follow the habitual physical activity;
- examination should be performed in the morning on an empty stomach after a night of fasting for 10-14 hours (at this time can not smoke or take alcohol);
- during the test, the patient should calmly lie down or sit, do not smoke, do not SuperCool and not to be engaged in physical work;
- the test is not recommended during and after the stressful effects, debilitating diseases, and after operations and delivery, with inflammatory processes, alcoholic cirrhosis of the liver, hepatitis, during menstruation, in diseases of the digestive tract with impaired glucose absorption;
- before performing the test should be excluded therapeutic procedures and reception of medicines (adrenaline, corticosteroids, contraceptives, caffeine, diuretics thyasidional series, psychotropic drugs and antidepressants);
- false positive results are observed in gipokaliemii, dysfunction liver, endocrinopathy.

After the first collection of blood from a finger examinee takes inside 75 g of glucose in 250 ml of water for 5 minutes (children - 1.75 g on 1 kg of body weight). In carrying out samples of obese persons glucose is added at the rate of 1 g per 1 kg of body weight, but not more than 100 g. For the prevention of nausea to a solution of glucose is desirable to add citric acid. After reception of glucose produce fence capillary blood through 1 and 2 hours, as these periods are the most indicative for the characteristics of a functional condition of insulyarnogo apparatus. Classic glucose tolerance test involves the study of blood samples on an empty stomach and after 30, 60, 90 and 120 minutes after administration of glucose.

Which doctor should I contact if there is a impaired glucose tolerance

  • Endocrinologist

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Do you feel disrupted glucose tolerance? You should be very careful approach to your health in general. People pay not enough attention to the symptoms of the disease and don't realize that these diseases can be critically dangerous. There are many diseases that in the beginning didn't manifest in our body, but in the end it turns out, unfortunately, it have already been treated too late. Every disease has its own specific features typical symptoms - called symptoms of the disease. Definition of symptoms is the first step in the diagnosis of diseases in general. You just need a few times a year to be screened by a doctor, not only to prevent a terrible disease, but also to maintain a healthy spirit in a body and the organism in general.

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Map of the symptoms and the types of disorders is intended solely for educational purposes. We strongly recommend do NOT self-medicate; on all matters relating to the definition of the disease and ways of its treatment, contact your doctor. Md-tips is not responsible for the consequences of use information posted on the site.