Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. May 9, 2021; 10(3): 29-39
Published online May 9, 2021. doi: 10.5409/wjcp.v10.i3.29
Repetitiveness of the oral glucose tolerance test in children and adolescents
Eirini Kostopoulou, Spyridon Skiadopoulos, Ioanna Partsalaki, Andrea Paola Rojas Gil, Bessie E Spiliotis
Eirini Kostopoulou, Ioanna Partsalaki, Bessie E Spiliotis, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Patras 26504, Greece
Spyridon Skiadopoulos, Department of Medical Physics, School of Medicine, University of Patras, Patras 26504, Greece
Andrea Paola Rojas Gil, Department of Nursing, University of Peloponnese, Tripolis 22100, Greece
Author contributions: Spiliotis BE and Kostopoulou E designed the study; Kostopoulou E, Skiadopoulos S and Partsalaki I participated in the acquisition of data; Skiadopoulos S, Partsalaki I, Rojas Gil AP and Spiliotis BE participated in the analysis and interpretation of data; Kostopoulou E and Skiadopoulos S drafted the initial manuscript; Spiliotis BE and Rojas Gil AP made critical revisions related to intellectual content of the manuscript; all authors approved the final version of the article for publication.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of the University General Hospital of Patras (Greece).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eirini Kostopoulou, MD, PhD, Consultant Physician-Scientist, Research Scientist, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Rio, Patras 26504, Greece. irekost@upatras.gr
Received: December 25, 2020
Peer-review started: December 25, 2020
First decision: January 18, 2021
Revised: January 25, 2021
Accepted: March 7, 2021
Article in press: March 7, 2021
Published online: May 9, 2021
Processing time: 118 Days and 22.9 Hours
ARTICLE HIGHLIGHTS
Research background

Fasting plasma glucose is used as a screening tool for the diagnosis of disorders of glucose metabolism due to its ease of performance. The oral glucose tolerance test (OGTT) has been proposed as a possibly useful screening method for the diagnosis of impaired glucose metabolism and increased risk for diabetes in children. Data regarding the most appropriate screening method to diagnose disordered glucose metabolism are inconclusive.

Research motivation

Additional information is needed in order to determine the usefulness of the OGTT in diagnosing impaired glucose metabolism.

Research objectives

To investigate the pattern of glucose, insulin and C-peptide responses in repeated OGTTs and to determine the diagnostic and prognostic value of the OGTT regarding the development of disorders of glucose metabolism.

Research methods

A 3-h OGTT was performed in 81 children and adolescents with excess weight or a strong positive family history of type 2 diabetes mellitus (T2DM), and the glucose, insulin and C-peptide responses were evaluated at multiple time points. The OGTT was repeated in a proportion of the patients and comparisons were made between the responses of glucose, insulin and C-peptide. The glucose, insulin and C-peptide concentrations between the two OGTTs were compared using the Mann Wilcoxon Test for unpaired data and the Wilcoxon Signed Rank test for paired data. Correlations between the body mass index or the age and the glucose, insulin or C-peptide concentrations during the OGTTs were assessed using Spearman’s rho correlation coefficient.

Research results

None of the patients with impaired fasting glucose exhibited repetitiveness of the finding in both OGTTs. Eighty percent of the subjects with impaired glucose tolerance during the 1st OGTT, had normal glucose concentrations at t = 120 min during the 2nd OGTT. Repetitiveness was observed for the diagnosis of T2DM in both OGTTs.

Research conclusions

In patients with profoundly impaired glucose metabolism, as in the case of T2DM, one OGTT is probably adequate for diagnosing the disorder. In patients with milder disorders of glucose metabolism, a second OGTT is possibly needed for confirmation. The OGTT seems to be superior to single measurements, such as fasting glucose, in diagnosing disorders of glucose metabolism, particularly mild glucose dysregulation, i.e., impaired fasting glucose and impaired glucose tolerance. Disorders of glucose metabolism are uncommon in overweight or obese children and adolescents.

Research perspectives

Further studies are needed in order to determine the possible repetitiveness of the OGTT in children and adolescents with risk factors for T2DM, such as increased weight or a positive family history. Further studies are needed in order to confirm the diagnostic and prognostic superiority of the OGTT with regard to glucose dysregulation, compared to single glucose measurements.