An Evaluation of the Fasting Blood-Glucose Level as an Index of Abnormal Carbohydrate Tolerance

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THE fasting blood-glucose level is widely used today as a means of screening for diabetes mellitus. Recent studies1, 2 have emphasized the inadequacy of this determination in detecting lowered carbohydrate tolerance. On the other hand, the determination of blood glucose after the administration of a known carbohydrate load is the best means of demonstrating abnormalities in carbohydrate metabolism.2 The carbohydrate load is best given in a standard form such as a solution of weighed glucose or as a carbohydrate hydrolysate.


The results of 1,057 consecutive glucose tolerance tests performed in our laboratory on 1,057 patients were reviewed to determine whether or not a correlation existed between the fasting blood-glucose level and the response to a standard carbohydrate load. Fasting patients were given a solution containing 100 gm. of glucose immediately after samples of their blood had been withdrawn for glucose determination. Specimens of venous blood were drawn at one- and two-hour intervals after the administration of the glucose. These were analyzed by means of the AutoAnalyzer using-the automated ferricyanide reduction method.3


The comparison of fasting blood-glucose levels with the results of the glucose tolerance tests appears in Table 1. For this study, the glucose tolerance tests were arranged in groups according to the following ranges of fasting blood-glucose levels: 80 mg. per 100 ml. or less, from 81 to 90 mg., from 91 to 100 mg., from 101 to 110 mg., and more than 110 mg. per 100 ml. Each of these categories was then further divided into. . .



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