Impaired glucose tolerance

Introduction Impaired glucose tolerance (IGT); impaired glucose tolerance previously referred to as asymptomatic diabetes, also known as chemical diabetes, recessive diabetes, pre-diabetes. IGT is an intermediate state in which glucose metabolism is between normal and diabetic. All patients with type 2 diabetes undergo almost the stage of impaired glucose tolerance.

Cause

Due to the relative or absolute deficiency of insulin in the body.

an examination

Related inspection

EEG check blood sugar

Diagnosis basis: fasting blood glucose 7.8mmol / L 11.1mmol / L.

Differential diagnosis

Due to a variety of diseases or factors can cause impaired glucose tolerance or increased fasting blood glucose, it must be differentiated from primary diabetes.

(l) Renal glucosuria: mostly due to renal tubular reabsorption, such as nephrotic syndrome, chronic nephritis, or due to defects in congenital tubular cell function, causing obstruction of renal tubular reabsorption of glucose, renal glucose threshold decline The patient's blood sugar is normal, but the urine sugar is positive. However, its glucose tolerance was normal and blood insulin was normal. Generally there is no "three more than one less" symptoms. Renal glucosuria occurs mostly in young and middle-aged men, and more men than women. A small number of women may have increased glomerular filtration rate during pregnancy, and temporary diabetes may also have diabetes, but it must be differentiated from primary diabetes.

(2) After meals, diabetes: due to the excessive absorption of sugar in the gastrointestinal tract, such as gastric jejunostomy, hyperthyroidism, autonomic dysfunction and severe liver disease, temporary hyperglycemia and urine sugar may appear after eating. However, oral glucose tolerance test, fasting blood glucose normal, half an hour and l hour blood glucose exceeded normal, 2 hours and 3 hours of normal or lower than normal blood glucose. In addition to liver disease, the intravenous glucose test was normal.

(3) Stressful diabetes: In the case of cerebrovascular accident, craniocerebral trauma, acute myocardial infarction and other diseases, temporary hyperglycemia and urine sugar may occur.

(4) secondary diabetes: pancreatic diabetes, such as pancreatitis, pancreatectomy, pancreatic cancer; endocrine diabetes, such as hyperthyroidism, pheochromocytoma, Cushing's syndrome, etc., from the history and clinical manifestations To be identified.

(5) Chronic disease Long-term physical activity reduction or bed rest, glucose tolerance will be reduced, but fasting blood glucose is generally normal. Hunger and malnutrition: In vivo, the ability of tissues to use glucose is weakened, and insulin secretion is reduced. Therefore, glucose tolerance can be reduced, and occasional diabetes can occur.

(6) Drugs: Some drugs may affect glucose tolerance, so it should be stopped for 3 to 7 days before the test. Even more than a month. Drugs that raise blood sugar are: adrenocorticotropic hormone such as cortisone, growth hormone, catechol gum, caffeine, furosemide, glucagon, indomethacin, isoniazid, nicotine, female oral contraceptives, phenol Tolamin, thiazide diuretics and phenytoin sodium. The drugs for lowering blood sugar include: tazobactam, propranolol, ethanol, salicylate, and sulfonamides.

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