Chanprasertpinyo Wandee, Bhirommuang Nattapimon, Surawattanawiset Titiporn, Tangsermwong Thanwarin, Phanachet Pariya, Sriphrapradang Chutintorn
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Am J Med Sci. 2017 Dec;354(6):581-585. doi: 10.1016/j.amjms.2017.08.007. Epub 2017 Aug 18.
Oral glucose tolerance test (OGTT) is a sensitive and reliable test for diabetes mellitus and impaired glucose tolerance (IGT). However, poor patient tolerance of glucose solutions is common. We aim to compare the diagnostic value of an ice cream test with a standard OGTT.
A total of 104 healthy adults were randomly assigned to either 75-g OGTT or ice cream, followed by a crossover to the other test.
Most patients were females (71%). Mean age was 37 ± 12 years, and body mass index was 24.2 ± 3.9kg/m. Diabetes mellitus and IGT, as diagnosed by 75-g OGTT, were 4.8% and 6.7%, respectively. The 2-hour plasma glucose levels were 110 ± 55.5mg/dL with 75-g glucose and 97.52 ± 40.7mg/dL with ice cream. The correlation coefficient of 2-hour plasma glucose for the 2 tests was 0.82 (95% CI: 0.75-0.87; P < 0.001). Discordant diagnostic results, based on 2-hour plasma glucose levels, were 9.61%. By using a combination of fasting plasma glucose and 2-hour plasma glucose values, the ice cream test would have missed 5.76% of those at high risk for diabetes mellitus (impaired fasting glucose and IGT) or diabetes.
An ice cream test may serve as an alternative to a 75-g OGTT. Before applying this test in clinical practice, it needs to be validated in a larger population.
口服葡萄糖耐量试验（OGTT）是诊断糖尿病和糖耐量受损（IGT）的一项敏感且可靠的检查。然而，患者对葡萄糖溶液耐受性差的情况很常见。我们旨在比较冰淇淋试验与标准OGTT的诊断价值。
总共104名健康成年人被随机分为75克OGTT组或冰淇淋组，之后交叉进行另一项检查。
大多数患者为女性（71%）。平均年龄为37±12岁，体重指数为24.2±3.9kg/m²。通过75克OGTT诊断出的糖尿病和IGT分别为4.8%和6.7%。75克葡萄糖组2小时血浆葡萄糖水平为110±55.5mg/dL，冰淇淋组为97.52±40.7mg/dL。两项检查的2小时血浆葡萄糖的相关系数为0.82（95%CI：0.75 - 0.87；P < 0.001）。基于2小时血浆葡萄糖水平，诊断结果不一致的比例为9.61%。结合空腹血浆葡萄糖和2小时血浆葡萄糖值，冰淇淋试验会漏诊5.76%的糖尿病高危人群（空腹血糖受损和IGT）或糖尿病患者。
冰淇淋试验可作为75克OGTT的替代方法。在临床实践中应用该试验之前，需要在更大规模人群中进行验证。
