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Glucose challenge test (50-g GCT) in detection of glucose metabolism disorders in peritoneal dialysis patients: preliminary study

BACKGROUND: The aim was to evaluate the clinical utility of the oral glucose tolerance screening test (50-g GCT—glucose challenge test) for the detection of glucose metabolism disorders (GMD) in peritoneal dialysis (PD) patients with normal fasting glucose levels. METHODS: The 50-g GCT was performed...

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Detalles Bibliográficos
Autores principales: Madziarska, Katarzyna, Zmonarski, Slawomir, Penar, Jozef, Krajewska, Magdalena, Mazanowska, Oktawia, Augustyniak-Bartosik, Hanna, Gołebiowski, Tomasz, Klak, Renata, Weyde, Waclaw, Klinger, Marian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375300/
https://www.ncbi.nlm.nih.gov/pubmed/25539618
http://dx.doi.org/10.1007/s11255-014-0900-1
Descripción
Sumario:BACKGROUND: The aim was to evaluate the clinical utility of the oral glucose tolerance screening test (50-g GCT—glucose challenge test) for the detection of glucose metabolism disorders (GMD) in peritoneal dialysis (PD) patients with normal fasting glucose levels. METHODS: The 50-g GCT was performed in 20 prevalent patients without history of diabetes before PD treatment onset, who had been on dialysis for a median time of 15.34 months. In addition, other indicators of glucose metabolism were measured: C-peptide, fasting insulin serum concentration, and the glycated hemoglobin level (HbA1c). The patients were prospectively followed for a median time of 25.8 months. RESULTS: 50-g GCT revealed GMD in 15 studied patients (75 %)—impaired glucose tolerance in 11 patients (55 %) and diabetes mellitus in four patients (20 %). HbA1c and insulin resistance, estimated by homeostasis model assessment, were elevated in two (10 %) and seven (35 %) patients, respectively. In patients with GMD, dietetic and pharmacologic interventions were performed. When the 50-g GCT was repeated at the end of the observation period, 12 (60 %) patients reported GMD, with no case of diabetes. CONCLUSION: 50-g GCT appears to be a simple and practical tool for the detection of GMD in PD patients with normal fasting glucose. Timely therapeutic intervention can effectively inhibit the progression of glucose intolerance during PD treatment.