UNIDAD DE ENDOCRINOLOG~A - SECCI(SN INVESTIGACIONES POLICLINtCO DE PEDIATRIA ~, BUENOS AIRES O R A L G L U C O S E T O L E R A N C E T E S T I N 100 N O R M A L C H I L D R E N * CARLOS F. K N o w OLGA RAMOS
JUAN C° CRESTO
ISIDORO L. DUJOVNE SaLVaDOR F. DE MAJO
The use of an oral glucose load as a method aimed at detecting alterations in clinically asymptomatic children requires an objective definition of what the range of normality is. Individual values of the oral glucose tolerance test ( O G T T ) in normal children show wide variations, and the range obtained in statistical studies of normal children (expressed as ~ +__ 2 SD, or Pa to P97) varies greatly from one author to the other 2, a. ~. 7.9. ,3. 1~, ~ (tab. 1). These differences may result from a number of factors, namely: the assay technique applied s. z0; whether glucose is measured in venous or capillary blood ,9. a3 in whole blood, in plasma, or in serumS°'2°; the anatomical site where blood is drawn 2a; the degree of physical activity before or during the test TM ,4. =; the amount and concentration of glucose administered ~' ~7, 20. ~, =s, etc. I n order to standardize our working conditions and define the O G T T normal range for these, this test was conducted on 100 normal children of our hospital population. bIATERIAL AND METHODS One hundred children, who judging by history and physical examination enjoyed perfect health, were selected among those attending the out-patient clinic of the Hospital de Pediatr~a 'Dr. Pedro de Elizalde'. The testing of children who had recently suffered a minor sickness was postponed for at least 30 days. All of the children tested had a negative family history for diabetes. For the purpose of this study it was considered 'positive family history for diabetes' when a father, mother, siblings, uncles, aunts, cousins, grandfathers or grandmothers were diabetics. Most of the subjects of this study belong to the lower middle class. All showed a good nutrition status and weight within _.+10% of the value corresponding to their height. The average caloric intake of the group under study was higher than the usual ca/culation of 1,000 kcal for the first year of age plus 100 kcal for each additional year. Fifty percent of these calories were taken as carbohydrates, 30% as lipids and 2095 as proteins, mostly of high biological value '8. The children maintained their usual diet on the days prior to the test. CoNe's recommendation 4 of administering a specific, high * Supported by Consejo National de Investigaciones Cient~flcas y Tkcnicas (Argentina), F.L.LP. - Casa Cuna and Qulmica Hoechst Argentina. Key-words: Interpretation o[ OGTT; Normal children; Oral glucose tolerance test (OGTT); Variation of blood sugar response. Received: September 12, 1975. Acta diabet, fat. I4, 95, 1977. 95
ORAL GLUCOSE TOLERANCE TEST IN i 0 0 NORMAL CHILDREaN
author
Danowski *
Cole et al. a,3
Drash etal, 7
Rosembloom is
Pickens ec M. ~3
Lestradet e t al.~
3O
t59
55
54
20O
300
0.12
4-16
1-12
1-13
3-15
1.75 g/kg
1.75 g/kg
1.75 g/kg
3 0 g/m 2
number of children age glucose administered
1.75
glkg
variable
method
t-Iagedorn-Jensen
aUtO-analyzer
glucose oxid~se
auto-analyzer
Somogyi.Nelson
Somogyi-Nelson
material used
capillary blood
capillary blood
capillary blood
Venous plasma
capillary blood
capillary blood
83-119
56-88
44-112
68-104
54-110 56-109 *
30
117-201
79-160
68-208
83-204
77-i93 85-196 *
60
86-182
68-149
53-189
69.157
57-169 67-174 *
120
92-152
58-130
51-150
70-134
61-141 63-136 *
I
41-125 46-131 *
i
time (rain)
180
82-110
47-105
47-t19
32-118
i
50-110 *
i
68-185 * 62-185 *
I
44-137 *
i 32-113
!
*
T a b l e 1 - N o r m a l b l o o d g l u c o s e r a n g e ( r a g / 1 0 0 m l ) d u r i n g t h e O G T T , as r e p o r t e d b y d i f f e r e n t a u t h o r s . T h e f i g u r e s c o r r e s p o n d to t h e ~ ± 2 S D r a n g e , e x c e p t f o r t h o s e c a r r y i n g a n a s t e r i s c , w h i c h r e p r e s e n t 3 ~ a n d 9 7 t~ p e r c e n t i l e v a l u e s .
age (years)
males
females
4-
JUAN C° CRESTO
ISIDORO L. DUJOVNE SaLVaDOR F. DE MAJO
The use of an oral glucose load as a method aimed at detecting alterations in clinically asymptomatic children requires an objective definition of what the range of normality is. Individual values of the oral glucose tolerance test ( O G T T ) in normal children show wide variations, and the range obtained in statistical studies of normal children (expressed as ~ +__ 2 SD, or Pa to P97) varies greatly from one author to the other 2, a. ~. 7.9. ,3. 1~, ~ (tab. 1). These differences may result from a number of factors, namely: the assay technique applied s. z0; whether glucose is measured in venous or capillary blood ,9. a3 in whole blood, in plasma, or in serumS°'2°; the anatomical site where blood is drawn 2a; the degree of physical activity before or during the test TM ,4. =; the amount and concentration of glucose administered ~' ~7, 20. ~, =s, etc. I n order to standardize our working conditions and define the O G T T normal range for these, this test was conducted on 100 normal children of our hospital population. bIATERIAL AND METHODS One hundred children, who judging by history and physical examination enjoyed perfect health, were selected among those attending the out-patient clinic of the Hospital de Pediatr~a 'Dr. Pedro de Elizalde'. The testing of children who had recently suffered a minor sickness was postponed for at least 30 days. All of the children tested had a negative family history for diabetes. For the purpose of this study it was considered 'positive family history for diabetes' when a father, mother, siblings, uncles, aunts, cousins, grandfathers or grandmothers were diabetics. Most of the subjects of this study belong to the lower middle class. All showed a good nutrition status and weight within _.+10% of the value corresponding to their height. The average caloric intake of the group under study was higher than the usual ca/culation of 1,000 kcal for the first year of age plus 100 kcal for each additional year. Fifty percent of these calories were taken as carbohydrates, 30% as lipids and 2095 as proteins, mostly of high biological value '8. The children maintained their usual diet on the days prior to the test. CoNe's recommendation 4 of administering a specific, high * Supported by Consejo National de Investigaciones Cient~flcas y Tkcnicas (Argentina), F.L.LP. - Casa Cuna and Qulmica Hoechst Argentina. Key-words: Interpretation o[ OGTT; Normal children; Oral glucose tolerance test (OGTT); Variation of blood sugar response. Received: September 12, 1975. Acta diabet, fat. I4, 95, 1977. 95
ORAL GLUCOSE TOLERANCE TEST IN i 0 0 NORMAL CHILDREaN
author
Danowski *
Cole et al. a,3
Drash etal, 7
Rosembloom is
Pickens ec M. ~3
Lestradet e t al.~
3O
t59
55
54
20O
300
0.12
4-16
1-12
1-13
3-15
1.75 g/kg
1.75 g/kg
1.75 g/kg
3 0 g/m 2
number of children age glucose administered
1.75
glkg
variable
method
t-Iagedorn-Jensen
aUtO-analyzer
glucose oxid~se
auto-analyzer
Somogyi.Nelson
Somogyi-Nelson
material used
capillary blood
capillary blood
capillary blood
Venous plasma
capillary blood
capillary blood
83-119
56-88
44-112
68-104
54-110 56-109 *
30
117-201
79-160
68-208
83-204
77-i93 85-196 *
60
86-182
68-149
53-189
69.157
57-169 67-174 *
120
92-152
58-130
51-150
70-134
61-141 63-136 *
I
41-125 46-131 *
i
time (rain)
180
82-110
47-105
47-t19
32-118
i
50-110 *
i
68-185 * 62-185 *
I
44-137 *
i 32-113
!
*
T a b l e 1 - N o r m a l b l o o d g l u c o s e r a n g e ( r a g / 1 0 0 m l ) d u r i n g t h e O G T T , as r e p o r t e d b y d i f f e r e n t a u t h o r s . T h e f i g u r e s c o r r e s p o n d to t h e ~ ± 2 S D r a n g e , e x c e p t f o r t h o s e c a r r y i n g a n a s t e r i s c , w h i c h r e p r e s e n t 3 ~ a n d 9 7 t~ p e r c e n t i l e v a l u e s .
age (years)
males
females
4-
